THE MANAGEMENT OF SUPRAVENTRICULAR TACHYC ARDIA IN INFANCY

Paroxysmal supraventricular tachycardia (PSVT) is the most common dysr hythmia in infancy: its management can usually be performed at primary pediatric care level. The Authors discuss the pathophisiology, the cl inical features and the therapeutic approaches of PSVT, also on the ba sis of their personal experience. Generally two different-mechanisms a re mostly responsible of PSVT: art atrial authomatic focus or a reentr y circuit. The EKG diagnosis is essentially based on the duration of Q RS complex and the features of the P wave. Vagal maneuvers (especially diving-reflex or ice-bag facial application) are the most effective t herapeutic procedures to stop PSVT. When these maneuvers are unsuccess ful, art intravenous bolus of ATP is actually recommended because of i ts strong and brief vagotonic effect. Digoxin - which can be used in a cute therapy as well - represents the classical manteinance therapy in most infants under one year of age. Amigodarone is much less employde d. In most cages the recovery of PSVT occurs spontaneously during the first year of life and, after this age, cases needing further therapy and or surveillance are quite uncommon. Ablation of authomatic focuses or accessory pathways is rarely necessary.