Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, Ohio.
Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, Ohio.
J Am Soc Echocardiogr. 2018 Oct;31(10):1146-1150. doi: 10.1016/j.echo.2018.05.001. Epub 2018 Jul 31.
Supraventricular tachycardia (SVT) is the most common sustained arrhythmia in children. Infants with SVT and ventricular preexcitation (Wolff-Parkinson-White syndrome) are known to have up to 30% prevalence of congenital heart disease (CHD). Infants without ventricular preexcitation who present with SVT at <1 year of age have a similar prevalence of CHD. However, for children without ventricular preexcitation who present with SVT at older ages, the prevalence of CHD is not known. The aim of this study was to determine the prevalence of CHD in older children and adolescents presenting with SVT without ventricular preexcitation, with the goal of providing guidance regarding the usefulness of echocardiography in this patient population.
Children aged 2 to 18 years presenting with confirmed SVT between January 2011 and December 2015 were included in this retrospective review. Patients with any history of ventricular preexcitation or preexisting heart disease were excluded. Medical records were reviewed, and electrocardiographic and echocardiographic findings were classified as normal, incidental, or abnormal.
Two hundred ninety patients met the inclusion criteria. Echocardiographic examinations were completed on 224 patients. Only one patient was found to have CHD, a moderate primum atrial septal defect. This patient was noted to have electrocardiographic abnormalities consistent with primum atrial septal defect.
For older children and adolescents with no known heart disease presenting with SVT without ventricular preexcitation, echocardiography may not be a necessary part of initial evaluation when the results of physical examination and electrocardiography are normal.
室上性心动过速（SVT）是儿童中最常见的持续性心律失常。已知患有 SVT 和心室预激（Wolff-Parkinson-White 综合征）的婴儿中，先天性心脏病（CHD）的患病率高达 30%。在<1 岁时出现 SVT 且无心室预激的婴儿，CHD 的患病率也相似。然而，对于年龄较大时出现 SVT 且无心室预激的儿童，CHD 的患病率尚不清楚。本研究旨在确定无心室预激且年龄较大的 SVT 患儿中 CHD 的患病率，目的是为该患者人群中超声心动图的实用性提供指导。
本回顾性研究纳入了 2011 年 1 月至 2015 年 12 月期间确诊为 SVT 的 2 至 18 岁患儿。排除任何心室预激或先心病病史的患者。回顾病历，将心电图和超声心动图结果分类为正常、偶发或异常。
290 例患者符合纳入标准。224 例患者完成了超声心动图检查。仅发现 1 例 CHD，为中型原发房间隔缺损。该患者的心电图异常与原发房间隔缺损一致。
对于无已知心脏病且无心室预激的年龄较大的 SVT 患儿，当体格检查和心电图结果正常时，超声心动图可能不是初始评估的必要部分。
