Anti-Arrhythmia Agents ; therapeutic use ; Child ; Humans ; Tachycardia, Atrioventricular Nodal Reentry ; drug therapy ; Tachycardia, Ectopic Atrial ; drug therapy ; Tachycardia, Ectopic Junctional ; drug therapy ; Tachycardia, Supraventricular ; drug therapy ; Tachycardia, Ventricular ; drug therapy

A clinical study was made on 189 cases of various types of arrhythmia diagnosed among 1,100 patients. Incidence of arrhythmia was 17.2% of the total cases (male 58.2%, female 41.8%). Of 189 cases of arrhythmias, 78(41.3%) had bundle branch block, 42(22.2%) atrial fibrillation, 18(9.5%) atrioventricular block, 15(8%) premature ventricular contraction, 6(3.2%) sinus arrhythmia, 6(3.2%) W.P.W. syndrome, 4(2%) premature atrial contraction, 3(1.6%) atrial flutter-fibrillation, 3(1.6%) ventricular bigeminy, 3(1.6%) intraventricular conduction defect, 2(1.1%) atrial flutter, 2(1.1%) nodal bigeminy, 2(1.1%) ventricular bigeminy, 1(0.5%) paroxysmal atrial contraction and 1(0.5%) A-V nodal rhythm, 1(0.5%) nodla premature contraction, 1(0.5%) paroxysmal atrial contraction and 1(0.5%) sinus arrest. Etiological diagnoses of patients with arrhythmia were rheumatic heart disease (21.7%), hypertensive heart disease (12.7%), arteriosclerotic heart disease (12.7%), thyrotoxic heart disease (1.6%), anemic heart disease(1.6%) congenital heart disease (2.6%), cerebral vascular accident (1.6%), essential hypertension (9%) cerebral arteriosclerosis (0.53%), cor pulmonale (2.1%). chronic myocarditis (1.6%), anemia (1.6%), chronic nephritis (1.6%), acute glomerulonephritis (0.53%) chronic hepatitis (1.1%), tuberculosis (4.2%), bronchiectasis (1.1%), leprosy (0.53%), epilepsy (0.53%) intoxication (2.6%) cardiac neurosis (11.6%) and unknown (8%). The cardinal symptoms consisted of palpitation, dyspnea, headache, edema, dizziness, cough, left chest pain. gastrointestinal complaints, chest discomfort (thightness), weakness and fatigability. The incidence of arrhythmia was highest in the 4 th decade.
Anemia ; Arrhythmia, Sinus ; Arrhythmias, Cardiac* ; Atrial Fibrillation ; Atrial Flutter ; Atrial Premature Complexes ; Atrioventricular Block ; Bronchiectasis ; Bundle-Branch Block ; Chest Pain ; Cough ; Diagnosis ; Dizziness ; Dyspnea ; Edema ; Epilepsy ; Female ; Glomerulonephritis ; Headache ; Heart ; Heart Defects, Congenital ; Heart Diseases ; Hepatitis, Chronic ; Humans ; Hypertension ; Incidence ; Intracranial Arteriosclerosis ; Leprosy ; Myocarditis ; Nephritis ; Neurocirculatory Asthenia ; Pulmonary Heart Disease ; Rheumatic Heart Disease ; Thorax ; Tuberculosis ; Ventricular Premature Complexes

Statistical analysis of 18,211 cases of electrocardiogram which were recorded in Chung-Ang University Hospital from January 1969 to December 162% of total cases(61% of male and 63% of female) and the incidence of normal electrocardiogram was decrease with aging. 2) Abnormal Q-wave was seen in 0.4% of total cases(0.5% of male and 0.3% of female) and the incidence of abnormal Q-wave was more common over 50 years of age. 3) Left axis deviation was seen in 1.1% of total cases(1.4% of male and 0.9% of female) and the incidence of left axis deviation was more common over 50 years of age. Right axis deviation was seen in 0.3% of total cases(0.3% of male and 0.4% of female) and the incidence of right axis deviation was more common under 30 years of age. 4) Left ventricular hypertrophy was seen in 3.6% of total cases(4.8% of male and 2.5% of female) and the incidence of right ventricular hypertrophy was more common under 30 years of age. 5) ST-segment depression was seen in 2.0% of total cases(2.2% of male and 1.9% of female) and the incidence of ST-segment depression was increased with aging. 6) T-wave inversion was seen in 1.6% of total cases (1.5% of male and 1.7% of female) and the incidence of T-wave inversion was increased with aging. 7) Atrioventricular block was seen in 1.4% of total cases(1.8% of male and 1.0% of female) and the incidence of atrioventricular block was more common over 50 years of age. 8) Incidence of complete left bundle branch block was 0.2% and was more common overs 60 years of age. Incidence of complete right bundle branch block was 1.1% and the incidence was more common over 50 years of age. Incidence of incomplete right bundle branch block was 3.0% and the incidence was more common under 40 years of age. 9) The incidence of premature beat was 2.7% of total cases, atrial fibrillation 1.5%, supraventricular tachycardia 0.2%, sinus tachycardia 7.5%, sinus bradycardia 2.2% and sinus arrhythmia 2.3%. 10) Low voltage was ssen in 3.8% of total cases and the incidence of low voltage was more common over 50 years of age.
Aging ; Arrhythmia, Sinus ; Atrial Fibrillation ; Atrioventricular Block ; Axis, Cervical Vertebra ; Bradycardia ; Bundle-Branch Block ; Cardiac Complexes, Premature ; Depression ; Electrocardiography* ; Humans ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Tachycardia, Sinus ; Tachycardia, Supraventricular

Cardiac arrhythmia which was observed during 5 years and 10 months from September 1975 to June 1981 on 11, 273 ECG records of the pediatric patients were analysed. Simple sinus arrhythmia and bundle branch blocks were excluded from this study. 602 cases of arrhythmia were seen among the 11,273 cases(5.3%). The types of arrhythmia in the order of frequency are: A-V block ectopic beat, multifocal rhythm, paroxysmal tachycardia, A-V junctional rhythm. A-V dissocation, atrial fibrillation, ventricular fibrillation and escape beat. The main underlying causes of the serious cardiac arrhythmia were congenital heart disease, open heart surgery, rhematic heart disease, cardiomyopathy and myocarditis.
Arrhythmia, Sinus ; Arrhythmias, Cardiac* ; Atrial Fibrillation ; Bundle-Branch Block ; Cardiomyopathies ; Child* ; Electrocardiography ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Infant* ; Myocarditis ; Tachycardia, Paroxysmal ; Thoracic Surgery ; United Nations ; Ventricular Fibrillation

PURPOSE: Radiofrequency catheter ablation (RFCA) has become an effective therapeutic modality for treating pediatric tachyarrhythmias. Using conventional RFCA catheters, ablation of parahisian accessory pathways may be difficult and have high risk for heart block. We reviewed the efficacy and complications of the RFCA in children and adolescent with arrhythmias including parahisian accessory pathways. METHODS: We studied 48 patients (aged 2 years to 20 years) who had undergone RFCA from August 2003 to March 2007. We reviewed clinical findings, electrophysiologic studies, RFCA data, complications, and follow-up results of the patients. RESULTS: Mean age of the patients was 13.1 years. Numbers and types of arrhythmias (age, acute success rate) were as follows: 19 WPW syndrome including 5 parahisian accessory pathways (13.74.6 yr, 18/19), 11 atrioventricular reentrant tachycardia with concealed bypass tract (12.35.0 yr, 10/11), 13 atrioventricular nodal reentrant tachycardia (12.64.4 yr, 13/13), 4 atrial flutter (13.07.4 yr, 3/4), and 1 ventricular tachycardia (20 yr, 1/1). Associated cardiac structural lesion was not detected in 48 patients. The recurrence rate was 6.5%, and the final success rate was 93.8%. CONCLUSION: These results suggest that RFCA is a highly effective treatment method in children and adolescent with tachyarrhythmia.
Adolescent* ; Arrhythmias, Cardiac ; Atrial Flutter ; Catheter Ablation* ; Catheters ; Child* ; Follow-Up Studies ; Heart Block ; Humans ; Recurrence ; Tachycardia* ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Ventricular ; Wolff-Parkinson-White Syndrome

PURPOSE: Radiofrequency catheter ablation (RFCA) has become an effective therapeutic modality for treating pediatric tachyarrhythmias. Using conventional RFCA catheters, ablation of parahisian accessory pathways may be difficult and have high risk for heart block. We reviewed the efficacy and complications of the RFCA in children and adolescent with arrhythmias including parahisian accessory pathways. METHODS: We studied 48 patients (aged 2 years to 20 years) who had undergone RFCA from August 2003 to March 2007. We reviewed clinical findings, electrophysiologic studies, RFCA data, complications, and follow-up results of the patients. RESULTS: Mean age of the patients was 13.1 years. Numbers and types of arrhythmias (age, acute success rate) were as follows: 19 WPW syndrome including 5 parahisian accessory pathways (13.74.6 yr, 18/19), 11 atrioventricular reentrant tachycardia with concealed bypass tract (12.35.0 yr, 10/11), 13 atrioventricular nodal reentrant tachycardia (12.64.4 yr, 13/13), 4 atrial flutter (13.07.4 yr, 3/4), and 1 ventricular tachycardia (20 yr, 1/1). Associated cardiac structural lesion was not detected in 48 patients. The recurrence rate was 6.5%, and the final success rate was 93.8%. CONCLUSION: These results suggest that RFCA is a highly effective treatment method in children and adolescent with tachyarrhythmia.
Adolescent* ; Arrhythmias, Cardiac ; Atrial Flutter ; Catheter Ablation* ; Catheters ; Child* ; Follow-Up Studies ; Heart Block ; Humans ; Recurrence ; Tachycardia* ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Ventricular ; Wolff-Parkinson-White Syndrome

Holter ECG monitoring is a continuous tape recording of a patient's electrocardiogram during ordinary activities and picks up hidden abnormalities in rate, rhythm or conduction. The authors delineated the types and incidence rates of arrhythmia in 32 normal Koreans by utilizing medical personnels and patients without evident heart diseases or symptoms, or significant systemic illness. Tracings and analysis were performed using 24 hour Holter monitoring processor(SCM 240, Fukuda, japan), auto-analyser (SCM-25), casette recorder(SM 24) and chrome tape. Results are as follows: 1) Portable 24 houre Holter ECG monitoring was performed in 32 persons(age range of 21 to 35) without cardiovascular disease, as defined by normal clinical and noninvasive cardiovascular examination. 2) During exercise, maximal heart rates ranged from 125.0+/-12.1/min and minimal rates from 96.7+/-5.8/min. During normal activity period, maximal and minimal heart rates were, respectively, 95.4+/-16.2/min and 62.6+/-6.3/min. Maximal sleep rates were 90.3+/-26.6/min and minimal sleep rates 57.4+/-12.4/min. 3) P-R interval decreased as heart rate increased. Transient first degree AV block was noted in 3 subjects(9.4%) and Wenckebach type second degree AV block in 2 subjects(6.3%). 4) Sinus tachycardia and bradycardia were observed in all subjects and sinus arrhythmia was more frequently noted during waking periods. Three subjects had episodes of sinus pause with maximum duration of 3.24 seconds. 5) In 13 persons(40.6%) having supraventricular premature beats, the frequency was 50.01+/-49.36/hr and in 14 persons having(44%) ventricular premature beats the frequency 26.33+/-18.83/hr. Transient ventricular tachycardia of 3 seconds' duration was observed in one subject under the extreme stressful environment. 6) ST segment elevation over 1mm was noted in 5 subjects(15.6%), of whom one had a nocturnal chest pain and ST segment depression over 1mm in 2 subjects. T wave inversion was also found during exercise(3.1%) and during sleep(9.4%).
Arrhythmia, Sinus ; Arrhythmias, Cardiac ; Atrioventricular Block ; Bradycardia ; Cardiac Complexes, Premature ; Cardiovascular Diseases ; Chest Pain ; Depression ; Electrocardiography* ; Electrocardiography, Ambulatory ; Heart Diseases ; Heart Rate ; Humans ; Incidence ; Tachycardia, Sinus ; Tachycardia, Ventricular ; Tape Recording

Supraventricular tachycardia (SVT) refers to a heterogeneous group of arrhythmias localized within the upper part of the heart (the His bundle or above). In general, the term SVT does not include atrial fibrillation. Common forms of SVT include atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, focal atrial tachycardia, and atrial flutter. Other, less common arrhythmias also fall under the category of SVT, including inappropriate sinus tachycardia and junctional reentrant/ectopic tachycardia. Paroxysmal supraventricular tachycardia refers to AVNRT and AVRT. SVTs can be identified and classified by clinical manifestation/physical examination, ECG, and/or electrophysiologic analysis.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Atrial Flutter ; Bundle of His ; Diagnosis, Differential* ; Electrocardiography ; Heart ; Tachycardia ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Sinus ; Tachycardia, Supraventricular*

The cardiovascular manifestations of hyperthyroidism are sinus tachycardia, paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter, atrioventricular block, bundle branch block, angina pectoris, heart failure, and cardiomyopathy. Though complete atrioventricular block is rare, it is important to recognize it in clinical practice because of the possibility of cardiac arrest. We experienced a 47-year-old female patient who had hyperthyroidism with complete atrioventricular block and developed cardiac arrest despite the initiation of an antithyroid drug. We could resuscitate successfully and inserted a temporary pacemaker, but eventually a permanent pacemaker was needed to prevent the recurrence of cardiac arrest. We report a rare case of complete atrioventricular block and cardiac arrest associated with hyperthyroidism with the review of references.
Angina Pectoris ; Atrial Fibrillation ; Atrial Flutter ; Atrioventricular Block* ; Bundle-Branch Block ; Cardiomyopathies ; Female ; Heart Arrest* ; Heart Failure ; Humans ; Hyperthyroidism* ; Middle Aged ; Recurrence ; Tachycardia, Sinus ; Tachycardia, Supraventricular

BACKGROUND AND OBJECTIVES: The mechanisms of supraventricular tachycardia (SVT) in children are known to have age-dependent distributions. However, the distribution of the mechanisms of tachyarrhythmia, as a whole, is not known in infants and children. The aim of this study was to evaluate the mechanisms of tachyarrhythmia in infants with a structurally normal heart. SUBJECTS AND METHODS: We retrospectively reviewed the mechanisms of tachycardia in 56 children with structurally normal hearts, who had had a tachyarrhythmia in infancy. The mechanisms of tachycardia were confirmed in surface electrocardiogram and by transesophageal, or transvenous, electrophysiological study. RESULTS: The majority of tachycardia during infancy were SVT, in 50 of the 56 (89%). In the infants with SVT, 29 (58%) had atrioventricular reentrant tachycardia using an accessory pathway, With a manifested accessory pathway were in 13 of the 29. Primary atrial tachycardia was found in 19 (38%: a chaotic atrial tachycardia in 10, an atrial flutter in 5 and an atrial ectopic tachycardia in 4). 6 (11%) had a ventricular tachycardia, and of these 5 had a verapamil-sensitive idiopathic left ventricular tachycardia. The most infrequent tachycardia during infancy was an atrioventricular nodal reentrant tachycardia, which occurred in only 2 (4%). 39% of the tachycardia during infancy occurred in the neonatal period. Atrioventricular nodal reentrant and ventricular tachycardia were not found during the neonatal period. CONCLUSION: The most frequent mechanism of tachycardia during infancy was SVT related, with an accessory pathway. Primary atrial and ventricular tachycardia were also found in nearly half the infants, and these were sometimes difficult to manage without understanding their precise mechanism.
Atrial Flutter ; Child ; Electrocardiography ; Heart* ; Humans ; Infant* ; Retrospective Studies ; Tachycardia* ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Ectopic Atrial ; Tachycardia, Supraventricular ; Tachycardia, Ventricular