RT Book, Section
A1 Doniger, Stephanie J.
A2 Tenenbein, Milton
A2 Macias, Charles G.
A2 Sharieff, Ghazala Q.
A2 Yamamoto, Loren G.
A2 Schafermeyer, Robert
SR Print(0)
ID 1155297288
T1 Dysrhythmias
T2 Strange and Schafermeyer's Pediatric Emergency Medicine, 5e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259860751
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1155297288
RD 2024/04/18
AB Dysrhythmias  are  classified  according  to  the  heart  rate,  QRS  width,  and  the  patient’s  clinical  stability.Sinus  bradycardia  in  the  neonate  always  requires  aggressive  evaluation  and  treatment.Infants  with  paroxysmal  supraventricular  tachycardia  (PSVT)  may  present  in  a  low  output  state  with  irritability,  poor  feeding,  tachypnea,  and  diaphoresis.An  accessory  pathway  is  the  most  common  mechanism  for  PSVT  in  the  child.  Digoxin  may  precipitate  ventricular  tachycardia  (VT),  and  therefore  should  only  be  used  under  the  supervision  of  a  pediatric  cardiologist.Atrial  fibrillation  or  atrial  flutter  associated  with  accessory  pathway  disease  or  hypertrophic  cardiomyopathy  (HC)  puts  a  child  at  high  risk  for  1:1  conduction  abnormalities,  ventricular  tachycardia,  and  sudden  death.Either  amiodarone  or  lidocaine  may  be  used  for  shock-refractory  ventricular  fibrillation  and  ventricular  tachycardia.Concerning  risk  factors  for  hypertrophic  cardiomyopathy  (HCM)  and  sudden  death  include  a  family  history  of  sudden  death,  exercise-induced  symptoms,  and  a  murmur  on  physical  examination.