Abstract
We previously demonstrated the high degree of reproducibility of exercise testing in detecting and evaluating childhood arrhythmias. We now assess the value of 24 hr. ambulatory monitoring (AMB) as compared to maximal treadmill exercise testing (EX). Sixteen children aged 5 to 16 years (mean 11) with known arrhythmias, but without underlying heart disease were studied by AMB and 2 separate EX. The occurrence, frequency, and severity of arrhythmias and their relationship to heart rate were noted and compared. Of 11 children with known ventricular arrhythmias (VA) [8 with ventricular premature depolarizations (VPD), 2 with ventricular tachycardia (VT), 1 parasystole], 9 were detected during both AMB and EX, while 2 (1 with VPD's and 1 with VT) were detected only during EX. Suppression of VA was observed at similar heart rates during both AMB and EX in 4, while 7 who suppressed during EX did not suppress during AMB due to insufficiently rapid heart rate. Of 5 children with supraventricular arrhythmias [3 with atrial premature depolarizations (APE) and 2 with sinus bradycardia], 1 with APD'u unexpectedly demonstrated marked bradycardia only during AMB.
In conclusion, in children: l) EX is more sensitive than AMB in the detection of serious ventricular arrhythmias, 2) AMB is more sensitive than EX in detecting and evaluating bradycardias, 3) AMB and EX each provide specific and unique information. Thus both are useful and complementary in evaluation of arrhythmias.
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Rozanski, J., Kupersmith, J., Herman, M. et al. EVALUATION OF ARRHYTHMIAS IN CHILDREN. EXERCISE TESTING VS. AMBULATORY MONITORING. Pediatr Res 11, 399 (1977). https://doi.org/10.1203/00006450-197704000-00180
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DOI: https://doi.org/10.1203/00006450-197704000-00180