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Sick sinus syndrome in children.

O Scott, F J Macartney, P B Deverall

    Archives of Disease in Childhood
    |February 1, 1976
    PubMed
    Summary

    Sick sinus syndrome in children (10-15 years) presents with slow heart rates and varied symptoms like dizziness or tachycardia. Inappropriate slow heart rates persisted even after exercise and atropine, necessitating interventions like pacemakers in severe cases.

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    Area of Science:

    • Pediatric Cardiology
    • Electrophysiology

    Background:

    • Sick sinus syndrome (SSS) is a cardiac arrhythmia affecting the heart's natural pacemaker.
    • Pediatric SSS is rare, with limited data on its presentation and management in adolescents.

    Purpose of the Study:

    • To describe the clinical presentation, diagnostic findings, and management of sick sinus syndrome in a cohort of young male patients.
    • To highlight the challenges in diagnosing and treating SSS in children, particularly the brady-tachycardia syndrome variant.

    Main Methods:

    • Retrospective analysis of 6 male patients diagnosed with SSS between 10-15 years of age.
    • Evaluation of resting and post-exercise electrocardiograms (ECGs), atropine response, and drug therapy efficacy.
    • Assessment of clinical outcomes, including syncope, dizziness, supraventricular tachycardia, and need for cardiac pacing.

    Main Results:

    • Patients presented with resting heart rates ≤60/min, with symptoms including syncope, dizziness, or recurrent supraventricular tachycardia.
    • The brady-tachycardia syndrome variant was resistant to digoxin therapy.
    • Inappropriately slow heart rates persisted after exercise and atropine administration in all patients.
    • Two patients with life-threatening syncope required cardiac pacemakers.

    Conclusions:

    • Sick sinus syndrome in adolescents can manifest with diverse symptoms and requires thorough diagnostic evaluation, including provocative ECG testing.
    • The brady-tachycardia syndrome variant in children may be refractory to standard medical management.
    • Early identification of inappropriately slow heart rates and abnormal P-waves is crucial for timely intervention, potentially including pacemakers.

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