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Archivos de Pediatría del Uruguay

On-line version ISSN 1688-1249


GONZALEZ LOZANO, Jaime; SANCHEZ PEREZ, Inmaculada; ABDALA ESTABLE, Diego  and  CASANOVA GOMEZ, Manuel. Cambios electrocardiográficos y arritmias en pacientes pediátricos con rabdomioma. Arch. Pediatr. Urug. [online]. 2007, vol.78, n.3, pp.217-221. ISSN 1688-1249.

The incidence of cardiac tumors in children is < 0,1%; most of them are benign and more than half of them are rhabdomyosarcoma. The majority regresses without symptoms. Frequently, depending on the tumors location, electrocardiographic changes can be seen, occasionally with ventricular tachyarrhythmia, auricular-ventricular blockage and supraventricular tachyarrhythmia due to accessory pathways. Our experience with patients who had rhabdomyosarcoma with arrhythmias and their evolution is described in this paper. 18 patients were included, nine boys with the diagnosis of rhabdomyosarcoma through image with an age average of 7,7 months old (one was done prenatal). Four patients (22%) had tuberous sclerosis associated. Follow–up was done for an average of 17 years. Of the 18 patients, seven had sinoatrial block (two isolated, three with first degree AV block, two with second degree block and ventricular extrasystoles), three started with VT/VF, one had neonatal bradyarrhythmia and seven with intermitent preexcitement (four with SVT), five died months after the diagnosis, two died prematurely due to uncontrollable ventricular arrhythmias, one had preoperative hemodynamic problems and two died inmedialtely after surgery (none had tuberous sclerosis). Of the 13 patients left, six needed surgery due to tumoral obstruction. One patient needed a cardiac pacing and another patient persist with electrocardiographic preexcitation, without tachyarrhythmia who is treated with â-blockers. Two have sinoatrial block, one of them first degree block. Of the rest three were operated and 16 had tumoral regression. Electrocardiographic alterations and arrythmias associated to tumors are frequent, malignant arrythmias can be fatal but most of them dissapear when surgery of the tumor is practiced.


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