The incidence of arrhythmias during exercise stress tests among children with Kawasaki disease: A single-center case series.
The incidence of arrhythmias during exercise stress tests among children with Kawasaki disease: A single-center case series.
复制标题
川崎病儿童运动压力测试期间心律失常的发生率：单中心病例系列。
DOI：
10.1111/chd.12864
复制
发表时间：
2019
影响因子：
0.3
通讯作者：
Miyake,ChristinaY
中科院分区：
文献类型：
--
作者：
Aggarwal,Varun;Sexson-Tejtal,Kristen;Lam,Wilson;Valdes,SantiagoO;delaUz,CaridadM;Kim,JeffreyJ;Miyake,ChristinaY
ObjectiveBased on 2017 guidelines, participation in competitive sports with prior history of Kawasaki Disease (KD) requires those with coronary artery aneurysms (CAA) z score ≥ 5 to undergo evaluation for evidence of inducible ischemia or arrhythmias. The use of exercise stress testing (EST) to evaluate arrhythmias among KD patients has never been reported. This retrospective single‐center case series study sought to describe the presence of inducible arrhythmias during EST in KD patients with or without CAA.MethodsSingle‐center retrospective review of medical records of patients diagnosed with KD between 1989‐2015 at Texas Children’s Hospital, Houston, Texas who underwent EST were included.ResultsAmong 1007 patients diagnosed with KD, 95 (9%) underwent 165 ESTs at a median time of 9.6 years (IQR 5.8‐11.3 years) from diagnosis. Of these 95 patients, 37 had normal coronaries, 21 dilated (z score 2 to <2.5), 10 small (5 >z ≥2.5), 12 medium (10>z ≥ 5 absolute dimension <8 mm), 10 large (z ≥10 or absolute dimension ≥8 mm), 5 severe (myocardial infarct or bypass graft). Supraventricular tachycardia was not seen. Ventricular arrhythmias during EST were uncommon and seen only among patients with CAA z ≥5. Ventricular tachycardia occurred in a single patient with a large CAA, known VT and ICD. High‐grade ventricular ectopy was seen in one patient who had severe CAA and underwent bypass grafting.ConclusionsArrhythmias on EST were noted only among patients with CAA z ≥5. The current guidelines are a reasonable approach to increasing healthy activity among KD patients. Clarification regarding which inducible arrhythmias meet criteria for activity restriction may be helpful to guide sport participation.
