Cardiac Arrhythmias in Libyan-Children: Hospital Based Study

Amnna Rayani; Zohra Elmagrbi; Elmukhtar Habas

Authors

Amnna Rayani Tripoli Children Hospital, Tripoli, Libya
Zohra Elmagrbi Tripoli Children Hospital, Tripoli, Libya
Elmukhtar Habas Tripoli Central Hospital, Tripoli, Libya

Keywords:

WPW, SVT, Tachyarrhythmia, ECHO

Abstract

Background: Regular sinus heart rate is very important for the heart to pump blood efficiently. In infant, children and young adults, Cardiac tachyarrhythmia occurs, and leads to different presentations.

Method: Medical records of 17251 patients were examined in Tripoli Children Hospital- Cardiology Outpatient Clinic- during Jan. 2004 to Dec 2008. Their clinical file records were reviewed retrospectively. Out of those records, 79 patients were found to have cardiac arrhythmias. All patients had ECG, ECHO and some had holter. Frequency, type of arrhythmia, age and presentation were assessed with excel and SPSS program.

Results: The patients mean age was 6.9 years, ranges between intrauterine-life to 15 years. There were 40 Females (51.1%) and 38 (48.9%) males. According to the age of presentation, they were divided into three-age groups. Patients of a less than one year old were 19 (3wks-8 months). There were 11 females (57.9%) and 8 males (42.1%). Sinus tachycardia was the most common presentation (52.6%) followed by heart failure (36.8%). Cough with breathless was reported only in (10% ).The mean heart rate was 205 beats/min. SVT was confirmed by ECG in 17 patients (89.4%) and WPW syndrome ECG findings were reported in two patients. Normal heart by ECHO was reported in 15 patients (78,9%). ASD, VSD, MR and low ejection fraction were reported in 4 different patients. Patients aged more than one year but less than10 years old were 27 patients (34.2 %). There were 12 females (44.4%), 15 males (65.5%). The mean heart rate in this group was 138 beats/min. Chest pain and palpitation, heart failure, palpitation only, palpitation and pallor 48.2%, 3.7%, 25.9%, 11.1% were presenting symptoms respectively. Two patients only had WPW ECG evidence, and the rest had SVT-ECG changes. Heart ECHO was normal in all patient of this age group. The third group age include children aged more than 10 years old (11-15 years). There were 32 patients, 18 female (56.3%), 14 male (43.7%). Their mean heart rate was 126 beats/min. Chest pain with palpitation was the commonest complaint (69%), followed by palpitation in 5 patients (19% ), while palpitation plus pallor, and tachycardia only was in 2 patients each (6.3% ). SVT was diagnosed by ECG in 30 patients (94%) and only one patient (6%) and other one (3%) had WPW-ECG changes presented with palpitation. By ECHO, one patient (3%) had mitral prolapsed, and other one had MR, while the rest had normal heart ECHO finding.

Conclusion: SVT is the commonest arrhythmia in childhood period, although other dysrhythmias occur. Parents’ education to symptoms and signs of SVT as well as certain techniques to terminate SVT at home are needed. Further, studies and education methods must be initiated to explore the importance of the problem.

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