Kriebel Thomas, Lindinger Angelika
Klinik für Kinder- und Jugendmedizin, Westpfalz-Klinikum Kaiserslautern, Hellmut-Hartert-Straße 1, 67655, Kaiserslautern, Deutschland,
Herzschrittmacherther Elektrophysiol. 2014 Sep;25(3):140-7. doi: 10.1007/s00399-014-0336-4. Epub 2014 Aug 6.
Based on invasive electrophysiological studies and ablation procedures of tachycardias in children and adolescents, the understanding and knowledge of the different tachycardia substrates have significantly increased in recent years. This article describes the underlying pathophysiological mechanisms together with the expected changes in electrocardiogram (ECG) of the four most common types of supraventricular tachycardia in children and adolescents without congenital heart defects: atrioventricular reentrant tachycardia, atrioventricular nodal reentrant tachycardia, focal atrial tachycardia and permanent junctional reentrant tachycardia. Furthermore, idiopathic ventricular tachycardia is described. The incidence, clinical symptoms, natural course and prognosis of each particular tachycardia will be specified . The pharmacological and interventional treatment will be the focus of other reports in this issue. Finally, the current recommendations for the approach to asymptomatic children and adolescents with preexcitation are discussed according to the current guidelines.
基于对儿童和青少年心动过速的侵入性电生理研究及消融手术,近年来对不同心动过速基质的理解和认识有了显著提高。本文描述了无先天性心脏病的儿童和青少年中四种最常见的室上性心动过速类型的潜在病理生理机制以及心电图(ECG)的预期变化:房室折返性心动过速、房室结折返性心动过速、局灶性房性心动过速和永久性交界性折返性心动过速。此外,还描述了特发性室性心动过速。将详细说明每种特定心动过速的发病率、临床症状、自然病程和预后。药物治疗和介入治疗将是本期其他报告的重点。最后,根据当前指南讨论了对无症状预激儿童和青少年的处理方法的当前建议。