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Our Experiences in the Treatment of Supraventricular Paroxismal Tachycardia

Introduction: we present our experiences in menagement of supraventricular paroxismal tachycardia (PSVT) in children without congenital heart disease Methods: Retrospective review of 33 out-hospital patients (mean age 7 years, 3 younger than 1 year) followed a mean of 14 months. From January 2000 to January 2005, 16 (48%) girls and 17 (52%) boys presented with PSVT. Nineteen (57.6%) patients have PSVT by surface ECG criteria and the rest were diagnosed by anamestic data. In one girl SVPT was diagnosed prenataly at the gestational age of 27th weeks and converted with medigoxine taken by mother. After the age of 4 months she had no therapy and no PSVT episodes. Preexcitation syndroms was found in 8 (25%) patients. Thirteen patients terminate acute episodes of PSVT by using vagal maneuvers (40.6%), 19 had chronic drug therapy (59.4%). Sotalol were taking 16 of them (84.2%), and 2 patients medigoxine. We succesfuly ended profilactic therapy with propafenone in one child at the age of 1 year with no recurrence of SVPT. Two girls underwent catheter ablation due to poor response to drug therapy. All patients younger than 1 year presented with heart failure. Leading symptoms in older patients were palpitations and chest pain. Prolonged episodes of SVPT were terminated with intravenous application of adenosine. Conclusion: Most patients with SVPT can be managed with physiological maneuvers (40.6%), with no ablation. Adenosine is a drug of choice for terminating SVPT and digoxine for the termination of intrauterine SVPT.

Supraventricular paroxismal tachycardia; therapy

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