Management and Outcomes of Paediatric Patients with Palpitations Examined in Our Clinic

Objective: We retrospectively reviewed the data of patients who presented to the paediatric cardiology clinic with complaints of palpitations. We aimed to describe the characteristics of these patients, the rhythm disorders that were detected, and the treatment methods with a particular attention on rare and vital diseases. Methods: In total, 1,680 patients aged 5-18 years who presented with palpitations at the paediatric cardiology clinic between January 2016 and June 2019 were enrolled. Of these, 714 (42.5%) were male and 966 (57.5%) were female. All the hospital records including electrocardiography, echocardiography, cardiovascular stress test, 24-h Holter monitoring, event recorder and genetic analysis results were reviewed. Results: The mean age of the patients was 13.5±3.2 years (range: 5-17.8 years). Palpitation was accompanied with chest pain in 218 patients, shortness of breath in 152 patients and weakness in 67 patients. Also, 726 Holter monitoring, 165 event recorder and 104 cardiovascular stress test results were evaluated. Dysrhythmia was detected in 306 patients (18.2%). The most common dysrhythmias were supraventricular extrasystoles (n=171, 55.8%) and ventricular extrasystoles (n=82, 26.8%). Five patients were diagnosed with non-sustained ventricular tachycardia (VT) episodes, one with long QTc syndrome and one with catecholaminergic polymorphic VT. Two patients were followed-up for arrhythmogenic right ventricular dysplasia (ARVD), 12 patients had mitral valve prolapsed (MVP), 8 had valvular heart disease caused by acute rheumatic fever (ARF) and 7 had bicuspid aortic valve (BAV). Conclusion: Palpitation is one of the common causes of outpatient clinic visits in children and it may be the first symptom of serious arrhythmias, although it is frequently associated with benign pathologies. Most life-threatening dysrhythmias can be detected by a thorough analysis of the patient using basic cardiological examination methods.