Seletti L, Squarcia U
Clinica Pediatrica Università di Parma, Cattedra di Cardiologia Pediatrica, Italia.
Pediatr Med Chir. 1987 Sep-Oct;9(5):537-41.
The knowledge of various dysrhythmias and their prognostic value permits the selection of appropriate diagnostic and management strategies. The most frequent pediatric dysrhythmias are described: premature atrial and ventricular contractions, supraventricular tachycardias, preexcitation syndrome, long Q-T syndrome, sick sinus syndrome, A-V blocks congenital and acquired. These arrhythmias may be related to structural abnormalities of the conduction system or may reflect temporary cardiac immaturity, as in the newborn, or may occur after surgical repair of a congenital cardiac lesion. It is important decide if the arrhythmias is benign and likely to resolve spontaneously or if it is potentially dangerous. Sometimes an arrhythmias indicates underlying extracardiac disease such as central nervous system disease, sepsis, hypoglycemia, drug toxicity, severe tissue hypoxia, electrolyte abnormalities. In these instances the treatment of the underlying cause will correct the rhythm abnormalities.
对各种心律失常及其预后价值的了解有助于选择合适的诊断和管理策略。文中描述了最常见的小儿心律失常:房性和室性早搏、室上性心动过速、预激综合征、长Q-T综合征、病态窦房结综合征、先天性和后天性房室传导阻滞。这些心律失常可能与传导系统的结构异常有关,也可能反映出暂时的心脏不成熟,如新生儿的情况,或者可能发生在先天性心脏病变的手术修复后。重要的是要确定心律失常是良性的且可能自发缓解,还是具有潜在危险性。有时,心律失常表明存在潜在的心外疾病,如中枢神经系统疾病、败血症、低血糖、药物毒性、严重组织缺氧、电解质异常。在这些情况下,治疗潜在病因将纠正节律异常。