Abstract 10393: Factors of Negativity of Electrophysiological Study in Children and Teenagers Complaining of Tachycardia
Background: When noninvasive studies remain negative, the diagnosis of unexplained tachycardia in the youth is a dilemma. Invasive electrophysiological study (EPS) requires generally anesthesia and hospitalization in young children. The purpose of the study was to determine the factors of negativity of transesophageal EPS in children and teenagers complaining of tachycardia.
Population: 267 children, aged from 6 to 19 years, mean 15±3, complained of tachycardia and had a normal ECG in sinus rhythm.
Methods: Transesophageal EPS was performed in out-patient clinic without sedation but in presence of parents; EPS consisted of atrial pacing and atrial stimulation with 1 and 2 extrastimuli in control state and after isoproterenol. Long-term Holter monitoring was systematic in patients with negative EPS.
Results: Supraventricular tachycardia (SVT)(AV node re-entrant tachycardia, AV re-entrant tachycardia, atrial tachycardia) was induced in 146 patients (group I) and EPS remained negative in 121 patients (group II). Age and gender of both groups did not differ significantly (15±3 vs 15±3)(female gender 46% in group I vs 56% in group II, 0.1). Feeling of dizziness or syncope with tachycardia was less frequent in group I (12%) than in group II (48%)(p<0.0001). Feeling of chest pain with tachycardia was less frequent in group I (2%) than in group II (28%)(p<0.0001). History of familial SVT tended to be less frequent in group I (11.5%) than in group II (6%)(0.07). Presence of corrected congenital heart disease (HD) or non cardiac disease was less frequent in group I (1.4%) than in group II (10%)(p<0.001). Long-term Holter monitoring confirmed the absence of organic supraventricular tachycardias in all patients of group II and indicated only a sinus tachycardia.
Conclusions: Neither the age and the gender can predict the nature of tachycardias in young patients. EPS remained negative in 45% of children complaining of tachycardia. Association of feeling of tachycardia with syncope, chest pain and presence of another disease were more frequent in patients complaining of tachycardia but with a negative electrophysiological study than in children with inducible SVT.
- © 2013 by American Heart Association, Inc.