Rapid and low-cost method to prove the nature of no documented tachycardia in children and teenagers without pre-excitation syndrome.
Identifieur interne : 000996 ( Ncbi/Checkpoint ); précédent : 000995; suivant : 000997Rapid and low-cost method to prove the nature of no documented tachycardia in children and teenagers without pre-excitation syndrome.
Auteurs : Béatrice Brembilla-Perrot [France] ; Laurent Groben ; Frédéric Chometon ; Jean Paul Lethor ; Philippe Admant ; Jean Louis Cloez ; Irina Popescu ; Cecile Marchal ; Juanico Cedano ; Ahmed Abdelaal ; Olivier Huttin ; Charif Tatar ; Nacima Benzaghou ; Berivan Azman ; Arnaud Terrier De La Chaise ; François MarçonSource :
- Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [ 1532-2092 ] ; 2009.
English descriptors
- KwdEn :
- Adolescent, Child, Electrophysiologic Techniques, Cardiac (methods), Electrophysiologic Techniques, Cardiac (trends), Humans, Mass Screening (methods), Pre-Excitation Syndromes (diagnosis), Reproducibility of Results, Sensitivity and Specificity, Tachycardia, Ventricular (diagnosis), Tachycardia, Ventricular (prevention & control).
- MESH :
- diagnosis : Pre-Excitation Syndromes, Tachycardia, Ventricular.
- methods : Electrophysiologic Techniques, Cardiac, Mass Screening.
- prevention & control : Tachycardia, Ventricular.
- trends : Electrophysiologic Techniques, Cardiac.
- Adolescent, Child, Humans, Reproducibility of Results, Sensitivity and Specificity.
Abstract
Aims Symptoms in children are often difficult to interpret. The purpose of this study was to report the results of transoesophageal electrophysiological study (EPS) performed in children complaining of sudden onset tachycardia with normal non-invasive studies. Methods and results Eighty-two children and teenagers (mean age 15 +/- 3 years) presented with suspected but no documented paroxysmal supraventricular tachycardia (SVT). ECG was normal. Non-invasive studies were negative; 23 children had syncope with tachycardias. They underwent transoesophageal EPS in our out-patient clinic. The mean duration of transoesophageal EPS was 11 +/- 5 min. Electrophysiological study was negative in 25 children. AV nodal re-entrant tachycardia could be induced in 37 children, 11 of them associated with syncope. Wolff-Parkinson-White syndrome (WPW) was diagnosed in five children in which atrioventricular re-entrant tachycardia was inducible. Atrioventricular re-entrant tachycardia due to a concealed AP was induced in 14 children. Verapamil-sensitive ventricular tachycardia was induced in one patient. Factors associated with tachycardia inducibility were an older age (15.5 +/- 2 vs. 14 +/- 4 years) (P < 0.05) and the absence of syncope (81 vs. 52%) (P < 0.05). During a mean follow-up of 3 +/- 1 year, no patient with negative EPS developed documented tachycardia. In 17 children with inducible SVT, radiofrequency ablation of the re-entrant circuit was subsequently performed. Conclusion Transoesophageal EPS is a fast method for proving the nature of paroxysmal tachycardia in children and teenagers presenting with normal ECG and for demonstrating WPW syndrome not visible on standard ECG. The negative predictive value of transoesophageal EPS for the diagnosis of SVT was 100%.
DOI: 10.1093/europace/eup093
PubMed: 19395417
Affiliations:
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pubmed:19395417Le document en format XML
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<author><name sortKey="Brembilla Perrot, Beatrice" sort="Brembilla Perrot, Beatrice" uniqKey="Brembilla Perrot B" first="Béatrice" last="Brembilla-Perrot">Béatrice Brembilla-Perrot</name>
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<author><name sortKey="Benzaghou, Nacima" sort="Benzaghou, Nacima" uniqKey="Benzaghou N" first="Nacima" last="Benzaghou">Nacima Benzaghou</name>
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<author><name sortKey="Azman, Berivan" sort="Azman, Berivan" uniqKey="Azman B" first="Berivan" last="Azman">Berivan Azman</name>
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<author><name sortKey="Terrier De La Chaise, Arnaud" sort="Terrier De La Chaise, Arnaud" uniqKey="Terrier De La Chaise A" first="Arnaud" last="Terrier De La Chaise">Arnaud Terrier De La Chaise</name>
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<author><name sortKey="Marcon, Francois" sort="Marcon, Francois" uniqKey="Marcon F" first="François" last="Marçon">François Marçon</name>
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<term>Child</term>
<term>Electrophysiologic Techniques, Cardiac (methods)</term>
<term>Electrophysiologic Techniques, Cardiac (trends)</term>
<term>Humans</term>
<term>Mass Screening (methods)</term>
<term>Pre-Excitation Syndromes (diagnosis)</term>
<term>Reproducibility of Results</term>
<term>Sensitivity and Specificity</term>
<term>Tachycardia, Ventricular (diagnosis)</term>
<term>Tachycardia, Ventricular (prevention & control)</term>
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<front><div type="abstract" xml:lang="en">Aims Symptoms in children are often difficult to interpret. The purpose of this study was to report the results of transoesophageal electrophysiological study (EPS) performed in children complaining of sudden onset tachycardia with normal non-invasive studies. Methods and results Eighty-two children and teenagers (mean age 15 +/- 3 years) presented with suspected but no documented paroxysmal supraventricular tachycardia (SVT). ECG was normal. Non-invasive studies were negative; 23 children had syncope with tachycardias. They underwent transoesophageal EPS in our out-patient clinic. The mean duration of transoesophageal EPS was 11 +/- 5 min. Electrophysiological study was negative in 25 children. AV nodal re-entrant tachycardia could be induced in 37 children, 11 of them associated with syncope. Wolff-Parkinson-White syndrome (WPW) was diagnosed in five children in which atrioventricular re-entrant tachycardia was inducible. Atrioventricular re-entrant tachycardia due to a concealed AP was induced in 14 children. Verapamil-sensitive ventricular tachycardia was induced in one patient. Factors associated with tachycardia inducibility were an older age (15.5 +/- 2 vs. 14 +/- 4 years) (P < 0.05) and the absence of syncope (81 vs. 52%) (P < 0.05). During a mean follow-up of 3 +/- 1 year, no patient with negative EPS developed documented tachycardia. In 17 children with inducible SVT, radiofrequency ablation of the re-entrant circuit was subsequently performed. Conclusion Transoesophageal EPS is a fast method for proving the nature of paroxysmal tachycardia in children and teenagers presenting with normal ECG and for demonstrating WPW syndrome not visible on standard ECG. The negative predictive value of transoesophageal EPS for the diagnosis of SVT was 100%.</div>
</front>
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<name sortKey="Azman, Berivan" sort="Azman, Berivan" uniqKey="Azman B" first="Berivan" last="Azman">Berivan Azman</name>
<name sortKey="Benzaghou, Nacima" sort="Benzaghou, Nacima" uniqKey="Benzaghou N" first="Nacima" last="Benzaghou">Nacima Benzaghou</name>
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<name sortKey="Groben, Laurent" sort="Groben, Laurent" uniqKey="Groben L" first="Laurent" last="Groben">Laurent Groben</name>
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<name sortKey="Lethor, Jean Paul" sort="Lethor, Jean Paul" uniqKey="Lethor J" first="Jean Paul" last="Lethor">Jean Paul Lethor</name>
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<name sortKey="Terrier De La Chaise, Arnaud" sort="Terrier De La Chaise, Arnaud" uniqKey="Terrier De La Chaise A" first="Arnaud" last="Terrier De La Chaise">Arnaud Terrier De La Chaise</name>
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<country name="France"><region name="Grand Est"><name sortKey="Brembilla Perrot, Beatrice" sort="Brembilla Perrot, Beatrice" uniqKey="Brembilla Perrot B" first="Béatrice" last="Brembilla-Perrot">Béatrice Brembilla-Perrot</name>
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