Clinical analysis of supraventricular tachycardia in children with different age in pediatric intensive care unit / 中国小儿急救医学

ABSTRACT

Objective:To analyze the clinical characteristics, severity of disease and treatment response of different anti-arrhythmic drugs in children with supraventricular tachycardia (SVT) hospitalized in PICU, providing few empirical messages for pediatricians.Methods:A retrospective study was conducted in children of different ages with SVT admitted to PICU at Shengjing Hospital of China Medical University from January 2012 to December 2019, collecting data regarding patients′ clinical features and curative effect of different drugs.Results:Among seventy-three cases, 53 cases(72.6%) were male and 20 cases(27.4%)were female, including 31 infant cases(42.5%), 15 toddler cases(20.5%), and 27 elderly children(37.0%). Main clinical manifestations for initially complains in sequence included: 36 cases(49.3%) with findings of fast heart rate, 12 cases(16.4%) with poor or rejective feeding with milk, 11 cases(15.1%)with discomfort of the precordial area, and 13 cases(17.8%) with fever or cough.By comparative of the clinical manifestations of patients, poor or rejective feeding with milk was more in infants group than the other two groups, findings of fast heart rate was more in toddler and elderly groups compared with infant group, and more elderly children with discomfort of the precordial area compared with the other two groups, which showed significant differences( P<0.05). Eighteen cases(24.7%)developed to congestive heart failure and six cases(8.2%)of them diagnosed with cardiac shock.Ratio of congenital heart disease and percentile of complicated with heart failure were higher in infant group compared with the other two groups, with significant difference( P<0.05). Fifty-four cases(74.0%)were successful turnover.Six cases(8.2%)were turnover with assistance of synchronized cardioversion.Five cases(6.8%)were failed in turnover, and four cases(5.5%)died. Conclusion:Children grouped with ages admitted to PICU with SVT show different clinical manifestations, variant electrocardiograms and underline diseases.Not all of SVT could successfully turnover with medications and synchronized cardioversion.Some cases would developed to life-threatening heart failure or cardiogenic shock, even death.