ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG CƠN TIM NHANH NHĨ ĐƠN Ổ Ở TRẺ EM TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Objective: To describe the clinical features, paraclinical findings, and characteristics of focal atrial tachycardia (FAT) in children at the Cardiovascular Center - National Institute of Paediatrics.Subjects: 32 patients diagnosed with focal atrial tachycardia (FAT) through electrophysiological study. Research Method: Cross-sectional descriptive study. Results: The mean age at intervention was 54.2 ± 57.3 months (ranging from 25 days to 17 years). The female/male ratio was 1.13:1. Dyspnea was the most common reason for admission (43.8%). The most frequent clinical symptom in children under 1 year old was dyspnea (75%), while children ≥1 year old commonly reported both dyspnea and fatigue (57.1% and 52.4%, respectively). During tachycardia episodes, electrocardiogram (ECG) showed P’ waves in 93.1% of cases, with 100% of RP' > P'R intervals, and predominantly narrow and monomorphic QRS complexes (96.6%). Holter 24-hour ECG monitoring detected atrial tachycardia in 53.1% of cases and premature atrial contractions in 71.9%. Electrophysiological study revealed the focal point of tachycardia predominantly in the right atrium in 23 out of 32 patients, with the most common site being the atrial crest in 13 out of 23 patients. Conclusion: Dyspnea is the most common clinical manifestation during tachycardia episodes. Identifying the P’ wave plays a crucial role in the diagnosis of atrial tachycardia. The origin of the tachycardia is not random within the entire atrium but tends to concentrate at specific anatomical sites.