CLINICAL CHARACTERISTICS, AND COURSE OF SINUS NODE DYSFUNCTION IN CHILDREN: A TEN YEARS SINGLE-CENTER EXPERIENCE


Sahin G. T., Kafali H. C., Sülü A., Sengül F. S., Haydin S., Guzeltas A., ...More

AEPC 2022 - 55th Annual Meeting of the Association for European Paediatric and Congenital Cardiology , Geneve, Switzerland, 25 - 28 May 2022, pp.481-482

  • Publication Type: Conference Paper / Full Text
  • City: Geneve
  • Country: Switzerland
  • Page Numbers: pp.481-482
  • Eskisehir Osmangazi University Affiliated: Yes

Abstract

CLINICAL CHARACTERISTICS, AND COURSE OF SINUS NODE DYSFUNCTION IN CHILDREN: A TEN

YEARS SINGLE-CENTER EXPERIENCE

Gulhan Tunca Sahin1, Hasan Candas Kafali2, Ayse Sulu3, Fatma Sevinc Sengul2, Sertac Haydin4, Alper

Guzeltas2, Yakup Ergul2

1Department of Pediatric Cardiology, Saglik Bilimleri University M. Akif Ersoy Thoracic and

Cardiovascular Surgery Center, Istanbul, Turkey; Deparment of Pediatric Cardiology, Saglik Bilimleri

University Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey

2Department of Pediatric Cardiology, Saglik Bilimleri University M. Akif Ersoy Thoracic and

Cardiovascular Surgery Center, Istanbul, Turkey

3Department of Pediatric Cardiology, Saglik Bilimleri University M. Akif Ersoy Thoracic and

Cardiovascular Surgery Center, Istanbul, Turkey; Department of Pediatric Cardiology, Osmangazi

University Medical Faculty, Eskisehir, Turkey

4Department of Pediatric Cardiovascular Surgery, Saglik Bilimleri University M. Akif Ersoy Thoracic

and Cardiovascular Surgery Center, Istanbul, Turkey

BACKGROUND AND AIM: To evaluate the clinical characteristics and outcomes of children diagnosed

with sinus node dysfunction (SND).

METHODS: This was a retrospective review of patients diagnosed with sinus node dysfunction in a

tertiary paediatric cardiology center in Turkey from January 2011 to November 2021.

RESULTS: In all, 51 patients (34/66.6% males) were included, with a mean age of 9.3±6.4 years and a

mean weight of 29.6±19.2 kg.The age inappropriate bradycardia and pauses were the most common

rhythm disturbance, and syncope and dizziness (n:23, 45%) were the most frequent initial

symptoms.Forty of the 51 patients (78%) had structural heart disease, thirty two of them had

congenital heart disease, most commonly AV septal defect (n:10), atrial septal defect (n:5) and

transposition of great arteries (n:4). Seven of them had also left atrial isomerism.The remaining

eleven patients were isolated. Two of our patients were siblings and had SCN5A mutation.Of the

total patient population, 29 patients (57%) had previously undergone a cardiac operation and except

one patient sinus node dysfunction developed after a surgical procedure. This patient had left atrial

isomerism and SND was diagnosed during 24 hours holter monitorization before surgery. The most

common surgical procedures were fontan operation in six, closure of atrial septal defect in five,

correction of AV septal defect in four, Senning operation in three, and abnormal pulmonary venous

connection anomaly repairment in two. Twenty nine (56%) patients (17 of them were after cardiac

surgery) were underwent pacemaker implantation. The mean interval between pacemaker

implantation and the previous operation was 5,1 years (range, 0-18.4 years). Five of them had

pacemaker implantation within the first 30 days after surgery. All symptomatic patients noted

resolution of symptoms after pacemaker implantation. During the mean follow-up time of 43±33.7

months, no mortality was seen.

CONCLUSIONS: Although SND is rare in children, it has been diagnosed with increasing frequency

with structural heart disease especially in patients who have undergone corrective cardiac surgery

related with atrial tissue. Since SND can occur at any time postoperatively, these patients should be

kept under constant control. If symptomatic sinus node dysfunction is confirmed, permanent pacing

is an effective therapeutic modality.