Incidence and potential prevention of life-threatening venticular and supraventicular tachyarrhythmias in children
Dr. Reusz György
SE I. Gyermekgyógyászati Klinika tanterme
Hormonal regulatory mechanisms
Dr. Rácz Károly
Dr. Kardos Attila
Dr. Zima Endre
Dr. Mogyorósy Gábor
Dr. Reusz György
Dr. Tory Kálmán
Dr. Hajdú Júlia
In my doctoral dissertation, I discussed the mechanism of life-threatening arrhythmias specific to the pediatric age group. I examined the incidence and etiology of fatal or near-fatal neonatal supraventricular tachycardia and pediatric out-of-hospital sudden cardiac arrest in Hungary to determine possible prevention methods.
My research studies showed that the incidence of pediatric out-of-hospital sudden cardiac arrest in Hungary corresponds to published data in the literature; however, the exact determination of etiology remains challenging because of the low survival rate. The Documentation system of medical rescue in Hungary does not allow the identification of families with pediatric sudden cardiac death and hinders the initiation of family screening.
The high prevalence of inherited arrhythmia syndromes in surviving children gives the chance of genetic testing in affected families for prevention, and the challenging early clinical diagnosis of channelopathies before clinical symptoms and cardiac arrest also highlights the significance of family screening.
My retrospective observational study demonstrated that in the neonatal age group, even supraventricular tachycardia has a non-negligible risk of fatal or near-fatal outcomes, and antiarrhythmic medication may contribute to it.
New findings of my research are the verification of the utility of the EGSYS score to diagnose cardiac syncope in children with channelopathies and to point out that challenging diagnosis of Class I/C proarrhythmia (QRS duration increase and ventricular tachycardia) in neonates may contribute to underestimation of its role in poor clinical outcome.
My answer to the principal question of my dissertation regarding prevention of potentially life-threatening arrhythmias in children is the following: Several children’s lives could be saved by the identification of families with pediatric sudden cardiac arrest and inherited arrhythmia syndrome to initiate genetic family screening, by a more effective diagnosis of pediatric cardiac syncope with EGSYS score and by increased alertness for proarrhythmia during intravenous therapy of neonatal supraventricular tachycardia with Class I/C antiarrhythmic drugs.