Outcome of Supraventricular Tachycardia in Children Admitted to Assuit University Children Hospital

Supraventricular tachycardia (SVT) is the most common symptomatic arrhythmia in the pediatric population, characterized by an abnormally rapid heart rate that originates above the ventricles-typically involving the atrial tissue or the atrioventricular (AV) node. It affects approximately

1 in 500 children. Clinical presentation varies by age. Infants may present with poor feeding, vomiting, irritability, lethargy, diaphoresis, or syncope, and may show signs of congestive heart failure if undiagnosed. Older children may report palpitations, chest discomfort, dizziness, shortness of breath, or syncope . Initial management of pediatric SVT follows the ABCDE approach (Airway, Breathing, Circulation, Disability, Exposure) to assess stability. In stable patients, treatment begins with VAGAL maneuvers, followed by ADENOSINE (0.1 mg/kg IV bolus), if needed. If adenosine fails, antiarrhythmic drugs such as β-blockers, flecainide, or amiodarone may be used. In unstable SVT, immediate synchronized cardioversion (0.5-2 J/kg) is indicated. For recurrent SVT, long-term management may include the FLEA approach: Flecainide, Lifestyle modification, Electrophysiologic study, and Ablation. Paroxysmal supraventricular tachycardias (SVTs) are considered benign if the electrocardiogram in sinus rhythm is normal, but their occurrence in children/teenagers is often associated with anxiety in parents, children and their doctors, and sometimes with embarrassing and invalidating symptoms.Invasive evaluation of tachycardia is rarely indicated for several reasons, including misdiagnosis or fear of hospitalization. Frequently, children/teenagers who complain of palpitations or tachycardia are only considered to be anxious, and for several months or years a false diagnosis of sinus tachycardia is given. It is important to provide education and counseling to patients and their families, including information about the condition, treatment options, potential complications, and psychological support. Outcomes of Supraventricular Tachycardia (SVT) in Children, Most children recover fully, either by outgrowing SVT or with curative ablation. Long-term survival is excellent, with no reduction in life expectancy in isolated SVT.. About 30-50% of infants outgrow SVT by age 1-2 . 70-85% of children do well with medications . <5% of infants with untreated SVT may develop heart failure . <1% are at risk of serious events like sudden death . Over 95% grow and develop normally. In this study, the outcome of SVT in pediatrics is assessed including the clinical and electrophysiological data , the most effective acute and long-term management and recurrence rates.