[Heart conduction disorders in pediatric practice].

Abstract

This study was prepared on the basis of the recent data published in the specialized literature, as well as on the personal experience of the authors, and is considered as a necessary updating in the field of heart rhythm disturbances which occur in the child. A review is presented of sinoatrial blocks, of atrioventricular conduction disturbances, and of intraventricular conduction abnormalities (branch blocks). A modern classification is used in the discussion of sinoatrial, and of atrioventricular blocks, with the three distinctive degrees (first degree block, second degree block--with type I and type II variants, and the third degree block). The authors have attempted, in their effort to present the data concerning each of the entities, to include a series of anatomical and electrophysiological notions, some of which represent modern acquisitions obtained by endocavitary electrocardiographic exploration, and which are considered to be essential for a good understanding of the material. An important place is given--for each of the entities discussed--to the etiological study, as well as to clinical semiology, and electrocardiography, to problems related to the positive and differential diagnosis, and to therapeutical means, as well as to evolution and prognosis. The study is concluded by a presentation of intraventricular conduction disturbances (branch blocks) which are evaluated in their distinct variants: the monofascicular block (single bundle block), the bi- and trifascicular bundle blocks, major or minor blocks, and functional rate-dependent blocks. In these cases also the authors have analysed etiologic aspects, the clinical picture, and the electrocardiographic aspects, as well as therapeutical, evolutive and prognostic features for each of the different forms.