Ildarova R A, Shkolnikova M A, Termosesov S A
Clinical Institute of Pediatrics named after Academician Y. E. Veltishev; RNIMU after N.I. Pirogov.
Kardiologiia. 2018 Dec 25;58(12):52-58. doi: 10.18087/cardio.2018.12.10191.
to assess specificities of course of the long-QT syndrome in children before and after implantation of cardioverter-defibrillator (ICD), and optimization of indications to ICD-therapy.
We included in this study 48 children with long-QT syndrome from 44 unrelated families (28 boys and 20 girls), who underwent ICD implantation at the mean age 11.8±3.8 years. Mean duration of follow-up after implantation was 5.2±2.8 years. Data from these children were compared with those from 59 children of comparable age and gender with long-QT syndrome from 46 unrelated families receiving antiarrhythmic therapy (β-adrenoblockers). We assessed clinical and electrocardiographic characteristics of the disease obtained at initial visit and their dynamics thereafter.
Children with long-QT syndrome and ICD were mainly probands with interval QT longer than 500 ms, recurrent syncope and often history of sudden cardiac arrest requiring high doses of β-adrenoblockers for control of ventricular tachyarrhythmias.
ICD implantation is an effective and safe method both of primary and secondary prevention of sudden cardiac death in children with long-QT syndrome.
评估儿童植入心脏复律除颤器(ICD)前后长QT综合征的病程特点,以及优化ICD治疗的适应症。
本研究纳入了来自44个无关家庭的48例长QT综合征患儿(28例男孩和20例女孩),他们在平均年龄11.8±3.8岁时接受了ICD植入。植入后的平均随访时间为5.2±2.8年。将这些患儿的数据与来自46个无关家庭接受抗心律失常治疗(β-肾上腺素能阻滞剂)的59例年龄和性别匹配的长QT综合征患儿的数据进行比较。我们评估了初诊时获得的疾病临床和心电图特征及其后续变化。
患有长QT综合征且植入ICD的患儿主要是QT间期超过500毫秒、反复晕厥且常有心脏骤停病史的先证者,需要高剂量的β-肾上腺素能阻滞剂来控制室性快速心律失常。
ICD植入是长QT综合征患儿原发性和继发性心脏性猝死预防的有效且安全的方法。