Does Atrioventricular Reentry Tachycardia (AVRT) or Atrioventricular Nodal Reentry Tachycardia (AVNRT) in Children Affec
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ORIGINAL ARTICLE
Does Atrioventricular Reentry Tachycardia (AVRT) or Atrioventricular Nodal Reentry Tachycardia (AVNRT) in Children Affect Their Cognitive and Emotional Development? Agnieszka Maryniak • Alicja Bielawska • Katarzyna Bieganowska • Maria Miszczak-Knecht Franciszek Walczak • Lukasz Szumowski
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Received: 23 July 2012 / Accepted: 11 October 2012 / Published online: 6 November 2012 Springer Science+Business Media New York 2012
Abstract The current study sought to assess cognitive and emotional functions among children and adolescents with atrioventricular reentry tachycardia (AVRT) and atrioventricular nodal reentry tachycardia (AVNRT). 113 patients (62 girls and 51 boys ages, 9–18 years) scheduled for radiofrequency ablation due to AVRT or AVNRT underwent neuropsychologic examination. The study excluded patients who had experienced cardiac arrest, congenital heart defects, neurologic disorders, or other diseases affecting cognitive or emotional development. Standardized tests for examining verbal and visual memory as well as visual–spatial functioning were performed. For patients exhibiting deficits in two or more tests, a diagnosis of ‘‘cognitive deficits’’ was determined. Levels of anxiety were tested using the State–Trait Anxiety Inventory. Cognitive deficits were found in 47.8 % of the patients. The age at first arrhythmia attack was related to memory dysfunction. The mean age at which the first symptoms occurred was significantly lower for patients with deficits (8.3 years) than for patients who had no deficit (10.2 years) (t = 2.15; p = 0.03). Boys exhibited a significantly higher level of trait anxiety than girls (t = 3.42; p = 0.0009). A significant negative correlation was found between anxiety and the age at appearance of the first symptoms (r = -0.26; p = 0.005). These findings led us to conclude that cognitive and emotional developments can be negatively affected by
A. Maryniak (&) A. Bielawska K. Bieganowska M. Miszczak-Knecht Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland e-mail: [email protected] F. Walczak L. Szumowski Institute of Cardiology, ul. Alpejska 42, 04-628 Warsaw, Poland
AVNRT and AVRT, particularly if tachycardia appears early in life. Keywords Adolescents Anxiety Atrioventricular nodal reentry tachycardia Atrioventricular reentry tachycardia Children Cognitive function
During childhood, the most symptomatic arrhythmia is atrioventricular reentry tachycardia (AVRT), which uses an accessory atrioventricular pathway or atrioventricular nodal reentry tachycardia (AVNRT). Tachycardia attacks can occur during the fetal period or in the first days or weeks of life, and although symptoms may resolve in infancy, they often recur in late childhood or adolescence. In other cases, tachycardia does not begin until the second decade of life [16, 19]. Tachycardia in children and adolescents generally is characterized by a faster heart rate than in adults but is relatively well tolerated. Its symptoms are difficult for caregive
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