Mariucci Elisabetta, Bronzetti Gabriele, Donti Andrea
Cardiologia Pediatrica e dell'Età Evolutiva, IRCCS Azienda Ospedaliero-Universitaria di Bologna.
G Ital Cardiol (Rome). 2024 Sep;25(9):640-649. doi: 10.1714/4318.43038.
Sudden cardiac arrest/death in pediatric patients is a rare but potentially preventable event. Cardiomyopathies and channelopathies are the most common causes which are detectable with ECG and transthoracic echocardiography in asymptomatic subjects. Coronary artery anomalies are a rare cause of sudden cardiac arrest/death, but these events suggest that ECG and echocardiography, focused on the site of origin of the coronary arteries, should be both part of the screening tool of young athletes. Finally, the rare cardiac arrest events in young patients with ventricular preexcitation without prior symptoms or markers of high risk suggest that transcatheter ablation should be considered in all pediatric patients with ventricular preexcitation because it can eliminate the small long-term risk of sudden cardiac arrest/death, but a careful consideration of the most appropriate timing is mandatory.
小儿患者的心搏骤停/猝死是一种罕见但有可能预防的事件。心肌病和离子通道病是最常见的病因,在无症状个体中可通过心电图和经胸超声心动图检测出来。冠状动脉异常是心搏骤停/猝死的罕见病因,但这些事件表明,聚焦于冠状动脉起源部位的心电图和超声心动图均应成为年轻运动员筛查工具的一部分。最后,无前驱症状或高危标志物的预激综合征年轻患者中罕见的心搏骤停事件提示,对于所有预激综合征小儿患者均应考虑行经导管消融术,因为它可消除心搏骤停/猝死的微小长期风险,但必须仔细考虑最合适的时机。