Paroxysmal supraventricular tachycardia (PSVT) is the most common dysrhythmia in infancy: its management can usually be performed at primary pediatric care level. The authors discuss the pathophysiology, the clinical features and the therapeutic approaches of PSVT, also on the basis of their personal experience. Generally two different mechanisms are mostly responsible of PSVT: an atrial automatic focus or a reentry circuit. The EKG diagnosis is essentially based on the duration of QRS complex and the features of the P wave. Vagal maneuvers (especially diving-reflex or ice-bag facial application) are the most effective therapeutic procedures to stop PSVT. When these maneuvres are unsuccessful, an intravenous bolus of ATP is actually recommended because of its strong and brief vagotonic effect. Digoxin - which can be used in acute therapy as well - represents the classical maintenance therapy in most infants under one year of age. Amiodarone is much less employed. In most cases the recovery of PSVT occurs spontaneously during the first year of life and, after this age, cases needing further therapy and or surveillance are quite uncommon. Ablation of automatic focuses or accessory pathways is rarely necessary.
|Number of pages||7|
|Journal||Rivista Italiana di Pediatria|
|Publication status||Published - 1994|
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health