Paroxysmal Supraventricular Tachycardia In Infants And Children: A Therapeutic Challenge

Abstract

Paroxysmal supraventricular tachycardia (PSVT) is the most prevalent and potentially life threatening tachyarrhythmia seen in children, having an incidence of 0.1 to 0.4%) . General practitioners, Pediatricians, Paediatric Cardiologists and Obstetricians should be aware that the condition in difficult to diagnose due to paucity of symptoms and can present in the fetus, in infants and in children. Management of this entity has changed over the last decade and the purpose of this entity has changed over the last decade and the pur- pose of this presentation is to review the changing trends in therapy.PSVT is a clinical diagnosis for a number of dysrhythmias that appear identical on the electrocar- diogram (ECG) but have different underlying pathogenetic mechanisms.Management is dependant upon the severity of hemodynamic decompensation (Figure 2). When as- sociated with shock, unconsciousness or severe con- gestive failure, immediate termination of the arrhythmia is necessary. PSVT in small infants is also an emergency because the exact duration of the tachyarrhythmia is unknown. Synchronized Direct Current (DC) cardioversion is done at an energy dose of 0.25 to 2.0 J/Kg, which can be doubled if necessary upto a total maximum dose of 10 J/Kg,12.