Primary bradycardia in children at Sohag University hospital: A single center experience

B. Atta, Mohamed Abdel Aal, S. Mahmoud
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Abstract

Background: Heart rate monitoring is usually used in pediatric early warning scores; primary bradycardia may cause high morbidity and rarely sudden cardiac death. Objective: Good assessment of primary bradycardia in children to allow proper management of critically ill child to prevent sudden death. Patients and methods: The study was prepared in Pediatric Arrhythmia Clinic, Emergency room department and outpatient clinic from March 2020 to August 2021. Children aged from 1day to 14 years presenting with 1ry bradycardia were enrolled in our study. Pre-death bradycardia was excluded. Full medical history, physical examination, basic investigations, 12 leads ECG and echocardiography were done to all included patients in this study. Holter monitoring was done while indicated. Results: 30 patients were included in the study. Heart rate ranged from 46 to 90 beat/minute with mean 67.44 bpm. 50 % of them had Syncopal attacks and another 50 % was diagnosed during routine examination. ASD detected in 20% of them, 20% had CHB; the remaining 60% were Idiopathic. Sinus bradycardia was present in 18 children, CHB was present in 6 patients while 1 st and 2 nd degree AV block were presenting in 6 children. Conclusion: Primary bradycardia in children needs early, good assessment and well management to decrease the need of acute intervention and preventing sudden death.
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索哈格大学医院儿童原发性心动过缓:单中心经验
背景:心率监测通常用于儿科预警评分;原发性心动过缓可能会导致高发病率,在极少数情况下会导致心脏性猝死。目标: 对儿童原发性心动过缓进行良好的评估,以便对其进行适当的管理:对儿童原发性心动过缓进行良好评估,以便对重症患儿进行适当管理,预防猝死。患者和方法:本研究于 2020 年 3 月至 2021 年 8 月在儿科心律失常门诊、急诊科和门诊进行。年龄在 1 天至 14 岁之间、出现急性心动过缓的儿童被纳入我们的研究。死亡前心动过缓除外。本研究对所有入选患者进行了全面的病史、体格检查、基本检查、12导联心电图和超声心动图检查。如有必要,还进行了 Holter 监测。结果研究共纳入 30 名患者。心率范围为 46 至 90 次/分,平均 67.44 次/分。其中 50% 的患者有晕厥发作,另外 50% 的患者在常规检查中被确诊。其中 20% 的患者被检测出 ASD,20% 的患者患有慢性阻塞性肺病,其余 60% 的患者为特发性。18 名患儿出现窦性心动过缓,6 名患儿出现慢性阻塞性心律失常,6 名患儿出现 1 度和 2 度房室传导阻滞。结论儿童原发性心动过缓需要早期、良好的评估和妥善的治疗,以减少急性干预和预防猝死的需要。
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