Background

Supraventricular tachycardia (SVT) is the most common sustained arrhythmia in children. Infants with SVT and ventricular preexcitation (Wolff-Parkinson-White syndrome) are known to have up to 30% prevalence of congenital heart disease (CHD). Infants without ventricular preexcitation who present with SVT at <1 year of age have a similar prevalence of CHD. However, for children without ventricular preexcitation who present with SVT at older ages, the prevalence of CHD is not known. The aim of this study was to determine the prevalence of CHD in older children and adolescents presenting with SVT without ventricular preexcitation, with the goal of providing guidance regarding the usefulness of echocardiography in this patient population.

Methods

Children aged 2 to 18 years presenting with confirmed SVT between January 2011 and December 2015 were included in this retrospective review. Patients with any history of ventricular preexcitation or preexisting heart disease were excluded. Medical records were reviewed, and electrocardiographic and echocardiographic findings were classified as normal, incidental, or abnormal.

Results

Two hundred ninety patients met the inclusion criteria. Echocardiographic examinations were completed on 224 patients. Only one patient was found to have CHD, a moderate primum atrial septal defect. This patient was noted to have electrocardiographic abnormalities consistent with primum atrial septal defect.

Conclusions

For older children and adolescents with no known heart disease presenting with SVT without ventricular preexcitation, echocardiography may not be a necessary part of initial evaluation when the results of physical examination and electrocardiography are normal.

中文翻译：

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超声心动图对儿童新发性室上性心动过速的作用

背景

室上性心动过速（SVT）是儿童中最常见的持续性心律不齐。患有SVT和心室预激的婴儿（Wolff-Parkinson-White综合征）的先天性心脏病（CHD）患病率高达30％。在<1岁时出现SVT的无心室预激的婴儿的CHD患病率相似。但是，对于没有心室预激的儿童，年龄较大时会出现SVT，尚不清楚冠心病的患病率。这项研究的目的是确定在没有心室预激的SVT的大龄儿童和青少年中，CHD的患病率，目的是提供有关超声心动图在该患者人群中的有用性的指导。

方法

这项回顾性研究纳入了2011年1月至2015年12月期间确诊SVT的2至18岁儿童。排除任何有心室预激或既往心脏病史的患者。审查病历，并将心电图和超声心动图检查结果分为正常，偶然或异常。

结果

290名患者符合纳入标准。超声心动图检查完成了224例患者。仅发现一名患有CHD（中度原发性房间隔缺损）的患者。注意到该患者的心电图异常与原发性房间隔缺损一致。

结论

对于没有已知心源性心脏病且没有室性预激的SVT的年龄较大的儿童和青少年，当体格检查和心电图检查结果正常时，超声心动图可能不是初始评估的必要部分。