Clinical Features and ECG Findings of Supraventricular Tachycardia in Pediatric Patients

Jang, Chang Hwan; Hyun, Myung Chul

Abstract

PURPOSE: Supraventricular tachycardia(SVT) is the most frequent symptomatic arrhythmia in children. We performed this study to disover the SVT mechanisms, age at SVT onset, symptoms and ECG findings of SVT and effect of adenosine on SVT.
METHODS
We studied 57 patients(male : 30, female : 27, age : 1 day-15.8 years) who had been admitted or transferred due to SVT from January, 1997 to March, 2001. Retrospectively we reviewed their medical records, ECG and electrophysiologic study findings.
RESULTS
Of the total 57 patients, the mechanisms of SVT(including atrial flutter) were atrioventricular reentrant tachycardia(AVRT) in 36(63%) patients, atrioventricular node reentrant tachycardia(AVNRT) in 9(16%) patients, ectopic atrial tachycardia(EAT) in 6(11%) patients, multifocal atrial tachycardia(MAT) in 3(5%) patients and atrial flutter(AF) in 3(5%) patients. Of the 12 primary atrial tachycardias(including EAT, MAT and AF), 11 tachycardias began before 1 year of age. The SVT occured before 1 year of age in 21(37%) patients, at 1 to 5 years of age in 7(12 %) patients, at 5 to 10 years of age in 19(33%) patients and after 10 years of age in 10(18%) patients. In symptomatic SVT, the frequent symptoms were palpitation, chest discomfort and chest pain, gastrointestinal symptoms including nausea and abdominal pain, dizziness and dyspnea in decreasing frequency. P wave was discernible in 31(86%) of the 36 AVRT patients and 5(56%) of the 9 AVNRT patients. Adenosine was effective in 19(91%) of 21 AVRT or AVNRT patients. No significant side effect resulted from was occured by rapid bolus intravenous injection of adenosine.
CONCLUSION
AVRT was most frequent in pediatric SVT patients. SVT frequently occured before 1 year of age and at 5 to 10 years of age. Primary atrial tachycardia mainly occured before 1 year of age.