Distribution of Tacyarrhythmia and Its Immediate Outcome Presenting In Pediatric Emergency Department at Tertiary Care Hospital

Abstract

Objective To determine the distribution of different types of arrhythmia and immediate outcome in children presenting in emergency department of a tertiary care hospital. Study Design: An observational analytical cohort study. Place and Duration: The department of cardiology, National Institute of Cardiovascular Diseases (NICVD), Karachi from January 2022 to July 2022. Methodology: A total of 91 children of both genders aged 1 day to 18 years presenting with one or more of the following symptoms: chest pain, bradycardia, tachycardia and/or syncope and diagnosed as cases of arrhythmia were included. Detailed medical history and information about demographic and clinical parameters were obtained. Complete general and cardiac examinations including 12 leads ECG, 2-D Echo study and the holter study for those with unexplained arrhythmias, syncope were performed. Distribution of arrhythmia types and immediate treatment outcomes were noted. Results In a total of 91 children, 46 (50.5%) were male. The mean age was 8.13 ± 4.45 year. Palpitation and chest pain were the commonest presenting symptoms reported in 87 (95.6%) and 25 (27.5%) children respectively. Acyanotic CHDs were found in 29 (31.9%) children. Supraventricular tachycardia (SVT) was observed to be the most frequent type of arrhythmias noted in 31 (34.1%) children while atrial fibrillation and ventricular tachycardia were the other most common arrhythmias noted in 19 (20.9%) and 15 (16.5%) children respectively. Amiodarone was the most frequent choice of treatment that responded well in 35 (38.5%) children and was mainly utilized in children with supraventricular tachycardia. Propranolol responded well in 34 (37.4%) children. Mean duration of hospital stay was 4.55 ± 3.32 days while mortality was noted in 4 (4.4%) children. Conclusion Palpitation and chest pain were the commonest presenting symptoms among children with arrhythmias. Supraventricular tachycardia, atrial fibrillation and ventricular tachycardia were the other most frequent types of arrhythmia. Overall outcome of arrhythmias treatment was good.