Management and outcome of children with supraventricular tachycardia presenting to the emergency room of a tertiary centre in Nigeria

Abstract

Background: Supraventricular tachycardia (SVT) is the commonest arrhythmias in children. Prompt and appropriate treatment with adenosine and other medicines can be lifesaving. Objectives: To determine the prevalence, management and outcome of children with SVT in an emergency room in a tertiary centre in Nigeria. Method: This prospective, cross sectional and descriptive study was conducted between June 2013 and May 2017 among children from birth to 17 years of age who had SVT. Clinical information was obtained with the aid of a proforma. Electrocardiogram and echocardiogram were performed. The subjects were managed with vagal manoeuvre and administration of available medicines including adenosine, beta blockers and digoxin. Their responses to the treatment offered and outcomes were noted. Data was entered into and analysed with IBM-SPSS version 20.0. Results: Twenty nine (0.4%) of 7693 children seen during the study period had SVT. The median age was 4 months and 12 (41.4%) were males. Seven (24.1%) were unconscious and 14 (48.3%) were either in heart failure or shock at presentation. Only four (13.8%) had adenosine while 17 (58.6%) received both beta blockers and digoxin of whom 50% responded. Eleven (37.9%) children died. Conclusions: In this study the prevalence of SVT was 0.4%. Whilst 08 (27.6%) children with SVT were treated only with vagal manoeuvres, 04 (13.8%) were treated with adenosine, 09 (31.0%) with metoprolol and 08 (27.6%) with digoxin. Mortality was 38%. Sri Lanka Journal of Child Health , 2018; 47 : 228-232