Abstract
The aim: to improve the early diagnosis of arrhythmia in combination with gastroesophageal reflux disease (GERD) in children, by studying the risk of connective tissue dysplasia on the occurrence of this pathology.
 Materials and methods. We examined 100 children aged 8 to 18 years, mean age 13.7±2.7 years, of which 32 children with arrhythmias without combined pathology were group I, 36 children with concomitant GERD - group II and 32 children with GERD without concomitant arrhythmias - group III. Patients underwent clinical and instrumental studies (electrocardiography, Holter daily ECG monitoring, esophagogastroduodenoscopy and pH-metry) and evaluation of phenotypic signs of NDST according to the criteria of T. Milkovskaya-Dimitrova and A. Karkasho.
 Results. A risk factor for the formation of combined pathology in children in the form of arrhythmia and GERD was identified, namely the next main phenotypic feature of NDST (undifferentiated connective tissue dysplasia) – dysplastic tooth growth.
 Also, predictors of both an isolated variant of arrhythmia in children and arrhythmia in combination with GERD – high height and scoliotic posture were identified.
 In this case, the risk factor for an isolated variant of arrhythmia in children, according to the results of the study is asthenic constitution.
 The severity of NDST in the studied groups was determined. The analysis of the results revealed the absence of a statistically significant relationship between the severity of NDST and study groups, although it should be noted that in children of group III the first degree of NDST was not observed in general.
 Conclusions. It was found that asthenic constitution, dysplastic tooth growth, tall stature and scoliotic posture are statistically significant risk factors for the development of the studied pathologies.
 There were no statistically significant differences between the study groups regarding the severity of NDST, but there was a complete lack of detection in children of group III (children with isolated GERD without concomitant arrhythmia) of the first degree of NDST
Highlights
In Ukraine and around the world there is a tendency to increase diseases of the digestive system in children [1, 2]
Materials and methods We examined 100 children aged 8 to 18 years with an average age of 13.7±2.7 years on the basis of the city cardiorheumatology department of “Children's Clinical Hospital No 24” of Kharkiv City Council and “City Children's Polyclinic No 23” of Kharkiv City Council in the period from September 2018 to July 2021, including 32 children with arrhythmias without concomitant pathology, who made up group I, 36 children with concomitant gastroesophageal reflux disease (GERD) – group II and 32 children with GERD without concomitant arrhythmia – group III
Dysplastic tooth growth was more common in children of groups II than in groups I and III, which may indicate that it is a risk factor for the formation of combined pathology in children in the form of arrhythmia and GERD
Summary
In Ukraine and around the world there is a tendency to increase diseases of the digestive system in children [1, 2]. The most common disease of the digestive system is GERD [3, 4]. GERD has a large number of different clinical symptoms, which is the cause of late diagnosis of the disease and leads to increased complications [5, 6]. The prevalence of arrhythmias in children tends to increase, which is a serious medical problem, because there are many variants of arrhythmias with a malignant course and a large number of life-threatening complications [7, 8]. Differential diagnosis between arrhythmias and GERD in children is complicated due to the similarity of the clinical picture of arrhythmias with the clinic of atypical cardiac manifestations of GERD. It is even more difficult to differentiate the isolated course of these pathologies with their course in the form of combined pathology [9, 10]
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