Author + information
- Reena Ghosh,
- Gregory J. Gates,
- Myles Schiller,
- Christine Walsh,
- Robert Pass,
- Lynn Nappo and
- Scott Ceresnak
Exercise testing is commonly performed in children for evaluation of cardiac disease. There are few data on the prevalence and types of arrhythmias observed during exercise testing in children.
A retrospective review of all patients < 21 years of age undergoing exercise testing at our center from 2008–2012 was performed. Patient demographics, hx of arrhythmias, echo findings, exercise data, arrhythmias during testing and interventions required were recorded. Chisquare was used for dichotomous variables, ANOVA for continuous data. P < 0.05 was considered significant.
1,037 tests were performed in 916 patients. Mean age was 14 ± 4 years, 537 (55%) were male, 281 (27%) had congenital heart disease (CHD), 178 (17%) had a hx of a prior arrhythmia or rhythm disorder, and 17 (2%) had a pacemaker. Testing was on the treadmill in 677 (65%), the bike in 360 (35%), and with cardio-pulmonary assessment in 400 (40%). The main indications for testing were: Chest pain/palpitations 319 (31%), CHD 281 (27%), arrhythmia hx 148 (14%), and syncope 108 (10%). The most common forms of CHD were: TOF 54 (5.2%), single ventricle 49 (4.7%) and aortic valve dx 36 (3.5%). 291 (28%) patients had a rhythm disturbance during the procedure, the most common being PVCs in 192 (19%) and PACs 53 (5%). Clinically important arrhythmias were noted in 34 (3%) patients and included: 19 (1.8%) increasing ectopy with exercise, 5 (0.5%) VT, 5 (0.5%) second degree AV block, 3 (0.3%) SVT, and 2 (0.2%) AFIB. All arrhythmias spontaneously resolved and none of the patients required cardioversion or acute anti-arrhythmic therapy. Variables associated with the development of a clinically relevant arrhythmia included: severe left ventricular (LV) dysfunction on echo (p<0.001) and a prior history of a documented arrhythmia or arrhythmia disorder (e.g. LQTS, p<0.001). There were no complications or adverse events related to testing.
A total of 29% of children developed a rhythm disturbance during exercise testing and 3% were clinically important. Severe LV dysfunction and a history of documented arrhythmia or arrhythmia disorder were associated with the development of a clinically important arrhythmia in children.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Congenital Cardiology Solutions: Congenital Electrophysiology and Genetics
Abstract Category: 13. Congenital Cardiology Solutions: Pediatric
Presentation Number: 1247-123
- 2013 American College of Cardiology Foundation