The results of surgery for tachyarrhythmias in children.

Tachycardia in children is generally considered harmful and frequently is transformed into so-called arrhythmogenic cardiomyopathy. The goal of this report was the investigation of the result of surgical treatment and how it was dependent on the type of tachycardia, the presence of combined, or concomitant heart pathology. We have operated on 146 patients at an age of 8 months to 16 years (mean 9.6 +/- 2.7 yrs) from 1982 until April 1, 1990. Surface mapping was performed in patients with WPW syndrome. All patients underwent electrophysiological study. The duration of the disease was 8.4 +/- 1.9 years. 89% of patients suffered from syncopal episodes. The heart rate during tachycardia exceeded 200 beats/min in 95% of children. In 98% of patients palpitation lasted more than 3 hours. Seven types of tachycardia were seen in operated children. All patients were divided into three groups depending on the absence or presence of CHD or several types of arrhythmia. Sixty-seven patients (45.8%) with so-called noncomplicated tachycardias (without additional heart disease) were included in group I. Forty-seven patients (32.2%) with tachycardia and CHD were in group II and 52 patients (21.9%) with multiple tachycardias that had life-threatening prognosis were in group III. The total efficacy of surgical treatment in group I was 97%. The worst results were in group II patients. The total positive results in this group was 81%. In group III patients with life-threatening arrhythmias, total efficacy was 93.8%.