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. 1975 Mar;37(3):339–344. doi: 10.1136/hrt.37.3.339

Bidirectional tachycardia in a child. A study using His bundle electrography.

D S Reid, M Tynan, L Braidwood, G R Fitzgerald
PMCID: PMC483978  PMID: 1138739

Abstract

This is a report of a case of bidirectional tachycardia in a 6-year-old girl with no evidence of any structural abnormality of the heart. The patient had never received digitalis. The arrhythmia appeared to be precipitated by effort and emotional stress, and could be induced by increasing the heart rate by atrial pacing or isoprenaline administration. His bundle electrography showed that the arrhythmia was ventricular in origin. This emphasizes the importance of recording an effort electrocardiogram in all children with unexplained syncopal episodes, even when the resting electrocardiogram is normal.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bekheit S., Morton P., Murtagh J. G., Fletcher E. Comparison of sinoventricular conduction in children and adults using bundle of His electrograms. Br Heart J. 1973 May;35(5):507–515. doi: 10.1136/hrt.35.5.507. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. CASTALLANOS A., Jr, AZAN L., CALVINO J. M. Simultaneous tachycardias. Am Heart J. 1960 Mar;59:358–373. doi: 10.1016/0002-8703(60)90299-4. [DOI] [PubMed] [Google Scholar]
  3. Cohen S. I., Deisseroth A., Hecht H. S. Infra-His bundle origin of bidirectional tachycardia. Circulation. 1973 Jun;47(6):1260–1266. doi: 10.1161/01.cir.47.6.1260. [DOI] [PubMed] [Google Scholar]
  4. FRASER G. R., FROGGATT P., JAMES T. N. CONGENITAL DEAFNESS ASSOCIATED WITH ELECTROCARDIOGRAPHIC ABNORMALITIES, FAINTING ATTACKS AND SUDDEN DEATH. A RECESSIVE SYNDROME. Q J Med. 1964 Jul;33:361–385. [PubMed] [Google Scholar]
  5. Feigenbaum H., Popp R. L., Wolfe S. B., Troy B. L., Pombo J. F., Haine C. L., Dodge H. T. Ultrasound measurements of the left ventricle. A correlative study with angiocardiography. Arch Intern Med. 1972 Mar;129(3):461–467. [PubMed] [Google Scholar]
  6. Fortuin N. J., Hood W. P., Jr, Craige E. Evaluation of left ventricular function by echocardiography. Circulation. 1972 Jul;46(1):26–35. doi: 10.1161/01.cir.46.1.26. [DOI] [PubMed] [Google Scholar]
  7. Gooch A. S., McConnell D. Analysis of transient arrhythmias and conduction disturbances occurring during submaximal treadmill exercise testing. Prog Cardiovasc Dis. 1970 Nov;13(3):293–307. doi: 10.1016/0033-0620(70)90004-6. [DOI] [PubMed] [Google Scholar]
  8. HORAN M., VENABLES A. W. Paroxysmal tachycardia with episodic unconsciousness. Arch Dis Child. 1962 Feb;37:82–85. doi: 10.1136/adc.37.191.82. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kastor J. A., Goldreyer B. N. Ventricular origin of bidirectional tachycardia. Case report of a patient not toxic from digitalis. Circulation. 1973 Oct;48(4):897–903. doi: 10.1161/01.cir.48.4.897. [DOI] [PubMed] [Google Scholar]
  10. LOWN B., GANONG W. F., LEVINE S. A. The syndrome of short P-R interval, normal QRS complex and paroxysmal rapid heart action. Circulation. 1952 May;5(5):693–706. doi: 10.1161/01.cir.5.5.693. [DOI] [PubMed] [Google Scholar]
  11. Morris S. N., Zipes D. P. His bundle electrocardiography during bidirectional tachycardia. Circulation. 1973 Jul;48(1):32–36. doi: 10.1161/01.cir.48.1.32. [DOI] [PubMed] [Google Scholar]
  12. ROMANO C., GEMME G., PONGIGLIONE R. ARITMIE CARDIACHE RARE DELL'ETA' PEDIATRICA. II. ACCESSI SINCOPALI PER FIBRILLAZIONE VENTRICOLARE PAROSSISTICA. (PRESENTAZIONE DEL PRIMO CASO DELLA LETTERATURA PEDIATRICA ITALIANA) Clin Pediatr (Bologna) 1963 Sep;45:656–683. [PubMed] [Google Scholar]
  13. Roberts N., Olley P. His bundle electrogram in children. Statistical correlation of the atrioventricular conduction times in children with their age and heart rate. Br Heart J. 1972 Nov;34(11):1099–1101. doi: 10.1136/hrt.34.11.1099. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Tynan M., Kaye H. H., Reid D. S., Ozme F., Hunter A. S. Proceedings: Assessment of left ventricle performance in infants, children, and adults using single plane cine-angiocardiography. Br Heart J. 1974 Apr;36(4):399–399. [PubMed] [Google Scholar]
  15. WENNEVOLD A., MELCHIOR J. C., SANDOE E. ADAMS-STOKES SYNDROME IN CHILDREN WITHOUT ORGANIC HEART DISEASE: ELECTROCARDIOGRAM AFTER EXERCISE AS A DIAGNOSTIC TOOL. Acta Med Scand. 1965 May;177:557–563. doi: 10.1111/j.0954-6820.1965.tb01863.x. [DOI] [PubMed] [Google Scholar]
  16. ZIMDAHL W. T., TOWNSEND C. E. Bidirectional ventricular tachycardia due to digitalis poisoning; response to potassium therapy and evaluation of arrhythmia mechanism. Am Heart J. 1954 Feb;47(2):304–312. doi: 10.1016/0002-8703(54)90258-6. [DOI] [PubMed] [Google Scholar]

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