Zusammenfassung
Unter den tachykarden Rhythmusstörungen ist die paroxysmale, supraventrikuläre Tachykardie (PSVT) mit einer Inzidenz von 0,1–0,4% die häufigste Arrhythmie, ventrikuläre Tachykardien treten weitaus seltener auf. Meist handelt es sich um eine atrioventrikuläre (AV) Reentrytachykardie (AVRT) unter Einbeziehung einer akzessorischen Bahn oder um eine AV-nodale Reentrytachykardie (AVNRT). Adenosin, welches selektiv die AV-Überleitung kurzfristig blockiert, wird bei beiden Formen erfolgreich zur Tachykardieterminierung eingesetzt. Neben der antiarrhythmischen Therapie als Rezidivprophylaxe gewinnt die elektrophysiologische Untersuchung mit Ablation als kuratives Verfahren bei Kindern, die älter als 5 Jahre sind, mit primären Erfolgsraten zwischen 86% und 97% zunehmend an Bedeutung. Eine frühzeitige Kontaktaufnahme mit einem pädiatrischen Elektrophysiologiezentrum ist zu empfehlen.
Abstract
Paroxysmal supraventricular tachycardia (SVT) is the most common type of tachyarrhythmia occurring with an incidence of 0.1–0.4%. The occurrence of ventricular tachycardia is significantly lower in children and adults. The most frequent types of SVT in children are atrioventricular reentry tachycardia (AVRT) mediated by an accessory pathway and AV-nodal reentry tachycardia (AVNRT) using fibres with different conduction capacities (dual physiology of the AV-node). Both types can be successfully terminated with adenosine which selectively blocks conduction through the AV-node. Long-term pharmacological therapy represents one therapeutic option for recurrent episodes of SVT but it is increasingly being replaced by radiofrequency catheter ablation, which represents a curative treatment of SVT with success rates between 86% and 97%, especially when applied in children older than 5 years. Thus, long-term management of children with tachyarrhythmias should include early contact with pediatric electrophysiological centres.
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Albinni, S., Hanslik, A. & Marx, M. Tachykarde Herzrhythmusstörungen im Kindes- und Jugendalter. Monatsschr Kinderheilkd 158, 1263–1278 (2010). https://doi.org/10.1007/s00112-010-2268-3
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DOI: https://doi.org/10.1007/s00112-010-2268-3
Schlüsselwörter
- Supraventrikuläre Tachykardie
- Ventrikuläre Tachykardie
- Antiarrhythmika
- Elektrophysiologische Untersuchung
- Katheterablation