Hypervagotonic binodal dysfunction in children. Features of the natural course
- Authors: Vasichkina ES1, Kruchina TK1,2, Lebedev DS1, Egorov DF1,3
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Affiliations:
- Federal North-West Medical Research Centre named after V.A. Almazov, Saint Petersburg, Russia
- Saint-Petersburg State Pediatric Medical University, Saint Petersburg, Russia
- First Saint Petersburg State Medical University named after I.P. Pavlov, Saint Petersburg, Russia
- Issue: Vol 96, No 4 (2015)
- Pages: 609-615
- Section: IX Russian Seminar dedicated to the memory of Prof. N.A. Belokon’
- URL: https://journals.rcsi.science/kazanmedj/article/view/2259
- DOI: https://doi.org/10.17750/KMJ2015-609
- ID: 2259
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Full Text
Abstract
Aim. To evaluate the clinical and electrophysiological picture of binodal disease in children, as well as studying the clinical course of this disease.
Methods. To study the clinical and electrophysiological picture of autonomic binodal disease, 426 patients under 18 years old were examined; the average age was 15.35±2.43 years (3-17.9). Patient’s complaints, medical history were examined, ECG, 24-hour ECG, stress ECG (treadmill or bicycle test), echocardiography, transesophageal electrophysiologic study were performed. In the case of a combination with pathological signs of sinus node dysfunction and atrioventricular node conduction disorders with the normalization of all parameters after the atropine administration, hypervagotonic binodal dysfunction was diagnosed. To assess the clinical course of the disease, a group of 72 children was selected, who were monitored repeatedly. Mean follow-up duration was 33 months.
Results. During the study period, sinus node dysfunction and atrioventricular blocks completely resolved in 14 (19.44%), seen as normal clinical picture with no complaints, normal heart rate, no signs of sinoatrial block or atrioventricular block, normalization of Wenckebach point position. Another 35 (48.62%) had only one node dysfunction resolved (either sinoatrial or atrioventricular - Wenckebach point position within the age normal values and/or atrioventricular block resolved). In 23 (31.94%) - deterioration of the sinus node and atrioventricular node dysfunction was observed.
Conclusion. There are significant differences in the frequency characteristics of heart rhythm and electrophysiological parameters of sinus node function in children with a favorable clinical course of binodal disease and progressive course of the disease.
About the authors
E S Vasichkina
Federal North-West Medical Research Centre named after V.A. Almazov, Saint Petersburg, Russia
Author for correspondence.
Email: Vasichkinalena@mail.ru
T K Kruchina
Federal North-West Medical Research Centre named after V.A. Almazov, Saint Petersburg, Russia; Saint-Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Email: Vasichkinalena@mail.ru
D S Lebedev
Federal North-West Medical Research Centre named after V.A. Almazov, Saint Petersburg, Russia
Email: Vasichkinalena@mail.ru
D F Egorov
Federal North-West Medical Research Centre named after V.A. Almazov, Saint Petersburg, Russia; First Saint Petersburg State Medical University named after I.P. Pavlov, Saint Petersburg, Russia
Email: Vasichkinalena@mail.ru
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