Age makes a difference: Symptoms in pediatric supraventricular tachycardia

Abstract

BackgroundSupraventricular tachycardia is a group of rhythm disturbances that affect 1 in 300‐1200 Australian children annually. The differentiation of supraventricular tachycardia (SVT) symptoms and age of onset according to their subtype is not well understood in the pediatric population. Most studies rely on ECG criteria only to characterize the subtype of the SVT, which is not applicable to all subtypes. The purpose of this study was to identify the symptoms and ages of onset of SVT subtypes, and to analyze whether ethnicity or severity correlated with the SVT subtype confirmed in an invasive Electrophysiology (EP) study.MethodsA retrospective analysis and prospective survey evaluated 364 patients who underwent an EP study at The Royal Children's Hospital, Melbourne between 2009 and 2015. Age of onset, symptoms, and ethnicity were collected by phone survey or medical records in addition to EP study diagnostic data, medication status, and follow‐up information about their symptom status following EP procedure. Patients were grouped according to their SVT subtype. Data analysis was performed using chi‐squared, Fisher's exact, and ANOVA statistical tests to determine associations between SVT substrates.ResultsTwo hundred and thirty‐three suitable cases of SVT were identified (131 men, 102 women) aged between 0 and 18 years. Atrioventricular Reentrant Tachycardia (AVRT) (n = 153) was the most common SVT subtype, followed by Atrioventricular Nodal Reentrant Tachycardia (AVNRT) (n = 55), Atrial Tachycardia (AT) (n = 17), and other SVT subtypes (n = 8) which included Atrial Fibrillation, Atrial Flutter, and Junctional Tachycardia. There was a male predominance in all subtypes, except for AVNRT. AVNRT patients had palpitations, dyspnoea, dizziness, and anxiety more than any other group, AVRT patients complained of vomiting most and patients with AT had the most fatigue. The mean age of symptom onset varied among groups, being earlier in AVRT, later in AVNRT with a significant difference between AVRT with unidirectional retrograde accessory pathway (URAP) and AVNRT subtypes (P < 0.01).ConclusionSome specific symptoms were strong discriminators between different SVT subtypes. Ethnicity did not have strong correlations with SVT subtype incidence. This study was able to show clinical differences among children with SVT due to AVRT (URAP) compared to AVNRT, allowing the prognosis and intended management of pediatric SVT to be anticipated by less invasive means.

Atrioventricular Nodal Reentrant Tachycardia and Orthodromic Reentrant Tachycardia in Patients of Narrow Complex Tachycardia During Electrophysiological Study

“…With the exception of AVNRT, all subtypes exhibited a male predominance. The mean age of symptom onset varied across groups, with AVRT being younger and AVNRT being older, with a significant difference between AVRT with unidirectional retrograde accessory pathway (URAP) and AVNRT subtypes (P 0.01) 20 After electrophysiological study (EPS), Catheter ablation is the gold standard for treating these individuals with atrioventricular reentrant tachycardia (AVRT), with excellent long-term outcomes and a low risk of complications.…”

Supraventricular Tachycardia in Children

“…Во всех случаях необходимо выполнить измерение артериального давления и оценку антропометрических показателей. Во время приступа характерны бледность кожных покровов, потливость, повышение температуры тела, полиурия [6,7].…”

Prognostic Value of Cardiac Troponin and Risk Assessment in Pediatric Supraventricular Tachycardia

“…Supraventricular tachycardia (SVT) is the most common group of arrhythmias in the pediatric population, with an incidence of up to 1 in 250 individuals [1]. There are various symptoms in pediatric patients, ranging from gastrointestinal, respiratory, to psychosomatic presentations, which are somewhat different from those of adult patients [2][3][4][5]. The diagnosis of SVT can be made by electrocardiogram and electrophysiologic studies by mapping the electrical conduction systems and identifying aberrant pathways [2].…”