儿童异位性房性心动过速:文献综述

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摘要

简介:异位房性心动过速(EAT)是一种不常见且具有潜在风险的心律失常,如果处理不当,会导致左心室功能障碍。在成人中,EAT 主要由病变的心房心肌引起,对抗心律失常药物的反应较差。由于儿童心肌尚未发育成熟,其传导组织的电生理特征也与成人不同,因此儿童 EAT 的特征可能与成人不同。目的:介绍儿童 EAT 的自然病史和治疗方法。材料和方法:研究材料包括在全球公认的电子数据库 PubMed、Medline 和 Google Scholar 中找到的有关儿童异位房性心动过速及其治疗的综述文章。研究结果心房异位性心动过速的诊断依据是出现窄复律心动过速(在无异常或原有束支传导阻滞的情况下),并伴有可见 P 波,心率过快。心率范围在 120 至 300 次/分(bpm)之间,通常高于 200 bpm,但也可能出现生理性心率。对于没有潜在心脏病的儿童,使用抗心律失常药物可有效治疗 EAT。儿童在服药后,EAT 通常会自然缓解(75%)。结论:使用抗心律失常药物可有效治疗无基础心脏病的儿童 EAT。研究结果表明,使用地高辛、β-受体阻滞剂和 I 类抗心律失常药物进行分步治疗可能是治疗 EAT 的最有效方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ectopic Atrial Tachycardia in Children: A Literature Review
Introduction: Ectopic atrial tachycardia (EAT) is an unusual and potentially risky arrhythmia that can result in left ventricular dysfunction if not properly managed. In adults, EAT is mainly caused by diseased atrial myocardium and responds poorly to antiarrhythmic drugs. The characteristics of EAT in children might be different from those in adults because of their immature myocardium and the different electrophysiologic characteristics of their conduction tissue. Purpose: To present the data on the natural history and treatment of EAT in children. Material and method: The study material consisted of reviewed articles on the topic found on the globally accepted electronic databases, PubMed, Medline and Google Scholar regarding the Ectopic atrial tachycardia in children and its treatment. Results: The diagnosis of atrial ectopic tachycardia is based on the presence of a narrow complex tachycardia (in the absence of aberrancy or pre-existing bundle branch block) with visible P waves at an inappropriately rapid rate. The rates range from 120 to 300 beats per minute (bpm) and are typically higher than 200 bpm, although physiologic rates may be observed. EAT in children without underlying heart disease can be effectively treated using antiarrhythmic drugs. Spontaneous resolution of EAT after medication in children was frequent (75%). Conclusion: EAT in children without underlying heart disease can be effectively treated using antiarrhythmic drugs. The results of studies suggest that a stepwise approach using digoxin, a beta-blocker, and a class I antiarrhythmic drug may be the most effective treatment for EAT
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