Arrhythmia in children with congenital valvular aortic stenosis Original article
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Abstract
Aortic valve stenosis (AS) is a risk factor for life-threatening ventricular arrhythmias. The aim of the study was to evaluate cardiac arrhythmias in children with varying degrees of severity of AS. The study included 60 children aged 5 to 18 years with AS. The control group consisted of 60 healthy children. All patients underwent 24-hour Holter ECG monitoring and Doppler echocardiography, in which the transvalvular pressure gradient (PG) and the index of left ventricular mass (LVMI) were evaluated. Depending on the severity of valve stenosis, the children were classified as: group I – 21 children with PG from 25 to 39 mmHg, group II – 27 children with PG from 40 to 69 mmHg, group III – 12 children with PG ≥ 70 mmHg. Ventricular arrhythmias were observed in 20 (33.33%) of older children with AS, and the difference of age between children with and without arrhythmia was statistically significant (p < 0.05). In group I, ventricular arrhythmia was observed in 4 (19%) children, in group II in 7 (22%), in group III in 9 (75%) children. The children with cardiac arrhythmias had a statistically significantly higher mean values of PG compared to children without arrhythmia (63.5 ± 27.0 mmHg vs 42.4 ± 15.1 mmHg) and significantly higher mean values of LVMI (101.9 ± 29.8 g/m2 vs 69.5 ± 19.2 g/m2).
Conclusions:
1. Risk of ventricular arrhythmias in children with AS increases with the age.
2. The severity of aortic valve stenosis has an impact on the incidence of ventricular arrhythmias.
3. Calculation of the left ventricular mass is important to determine patients with AS at risk of arrhythmia.
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