Introduction: Sudden cardiac death (SD) in children is a tragedy with preventive potential, sometimes prece-ded by obvious symptoms (syncope, palpitations) and sometimes sudden and without premonitory signs.
Methods: Since 1998, 1600 children with arrhythmias have been hospitalized at IBCV Timișoara for electro-physiological study. All patients with arrhythmias po-tentially curable by radiofrequency catheter ablation (RFCA) were subject of ablative therapy.
Results: Of all the patients surveyed, 43 patients (p) (2.68%) were at risk of SD: • 30p (69.7%) with Wolff-Parkinson-White syndrome (WPW) with short effec-tive refractory period accessory pathways (AP) <220 ms (3p with cardiac arrest by ventricular fibrillati-on (VF) resuscitated at home or at school, 20p with typical symptomatology for arrhythmias and 7p fully asymptomatic) • 2p (4.6%) with ventricular tachycar-dia (VT) degenerated into VF • 8p (18.6%) with long QT syndrome • 3p (6.9%) with Brugada syndrome Pa-tients with WPW were treated with RFCA, 28p in one step, 2p in two steps (multiple AP). There were found 6 p with multiple AP. In 9p atrial fibrillation was indu-ced. Atrial fibrillation with preexcited QRS complexes and a minimal RR interval of 200 ms with heart rate ≤250/min degenerated into VF in 2 cases. RFCA was sucessfully performed in all patients. Five p with SQTL and 2p with Brugada received an implantable cardiac defibrillator.
Conclusions: SD in children with apparently normal heart can be preceded by obvious symptoms or not. Addressing patients in specialized centers of cardiac electrophysiology may reinstate the child in the safety area by RFCA or a cardiac defibrillator implantation and appropriate medication.