INTEGRAL VALUES OF ELECTROCARDIOGRAPHY IN SICK CHILDREN WITH PREMATURE VENTRICULAR EXCITATION

Аннотация

Premature ventricular excitation syndrome means that the ventricular myocardium is activated by atrial impulses conducted through accessory pathways (AP) before the impulses reach the ventricles through the normal cardiac conduction system. Manifestations of PVS are rare - from 0.15 to 3.1% of the general population, including 9% of the total number of children with cardiac arrhythmias. This disease manifests itself in different forms - from constant clinical and electrophysiological manifestations in the manifest form to the absence of any subjective and objective symptoms in the latent form. The clinical significance of PVS is determined by the fact that almost 80.0% of patients sooner or later develop tachyarrhythmic attacks, both paroxysmal (i.e. transient) and chronic (constant - recurrent form) tachyarrhythmia, atrial fibrillation, atrial flutter, which under certain conditions are transformed into atrial and ventricular fibrillation, posing a threat to the patient's life. Key words: arrhythmia, ventricular pre-excitation, hypertrophy, children, hearts. Introduction. Analysis of cited literature sources shows that the frequency of PVH both among adults and children has not been established, there is no consensus 41 “JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN UZBEKISTAN” JURNALI VOLUME 2, ISSUE 9, 2024. SEPTEMBER ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869 on the mechanisms of PVH development, cardiac and extracardiac factors transforming PVH into tachyarrhythmias have not been established, diagnostic errors in the interpretation of ECG - manifestations of PVH (myocardial infarction, myocarditis, congenital and acquired heart defects, mitral regurgitation, thyrotoxicosis, neurosis, syncope, etc.) are frequent [3]. Despite the advances achieved in the study of electrophysiological features of the AP, in the pathogenesis of arrhythmias in them [4], the action of antiarrhythmic drugs, indications and tactics of surgical treatment of PVH, the identification of reliable diagnostic criteria that allow timely recognition of life-threatening arrhythmias in these patients remains relevant [5]. Despite the numerous methods proposed in the diagnosis of PVH, ECG research has remained until recently the only method that allows for the topical diagnosis of PVH in children with PVH. The purpose of the study. To study and provide general clinical characteristics of sick children with various forms of PVH in school-age children in terms of additional diagnostic capabilities of electrocardiography. In clinical electrocardiology, the search for informative signs reflecting the activity of ventricular de- and repolarization processes continues to this day. In this regard, in age-specific electrocardiology, the study of planimetric parameters of the ventricular complex, the development of integral values (axonometric parameters) of de- and repolarization processes is more promising. Table 4.15 - 4.16 presents the ECG features of the ventricular QRS complex teeth in healthy and sick children with PVH in the age periods of 7 - 10 years and 11 - 14 years. 42 “JOURNAL OF SCIENCE-INNOVATIVE RESEARCH IN UZBEKISTAN” JURNALI VOLUME 2, ISSUE 9, 2024. SEPTEMBER ResearchBib Impact Factor: 9.654/2024 ISSN 2992-8869 Таблица 4.15 Амплитудные показатели и некоторых соотношений зубцов желудочкового комплекса ЭКГ здоровых и больных детей с ПВЖ в возрасте 7-10 лет (M±m) Контрольная Синдром WPW Феномен WPW Синдром CLC Феномен CLC Феномен № Показатели группа n=50 n=4 n=7 n=9 n=11 Махайма n=4 1 R I, мм 7,63±0,25 7,75±1,42 6,17±0,53 5,66±0,59 6,30±0,45 5,00±0,84 2 R III, мм 8,55±0,14 6,25±1,12 6,83±0,74 9,57±1,19 9,30±0,08* 6,50±1,96* 3 SI -3,28±0,045 -0,25±0,07 -1,0±0,52 -1,0±0,12 -0,60±0,44 -1,50±0,28 4 SIII -2,72±0,03 -3,0±1,13* -0,75±0,18 -0,33±0,14 -0,20±0,11 -0,50±0,56 5 RV I 6,1±0,11 5,0±0,42 3,33±0,71 2,67±0,36 4,40±0,42 2,50±0,51 6 SV I -9,6±0,18 -4,0±1,03 -0,66±0,47 -7,66±0,27 -8,40±1,31* -0,50±0,33 7 RV 6 14,7±0,32 14,3±1,96* 14,2±1,94* 14,1±0,59* 13,8±1,19* 14,8±1,92* 8 SV 6 -3,26±0,05 -1,5±0,46 -1,33±0,23 -0,67±0,29 -0,80±0,22 -1,75±0,28 9 TV I -0,32±0,03 -2,75±0,66 -0,67±0,18 -1,33±0,13 -1,50±0,32 -2,75±0,7 10 TV 6 3,56±0,09 2,75±0,66* 5,27±0,71 3,33±0,48* 2,90±0,44* 5,50±0,84 11 RV 6+SV1 24,2±,033 10,3±1,18 14,3±1,94 20,2±2,38* 22,2±1,96* 14,8±1,68 12 RV 1+SV6 9,65±0,39 6,5±1,68* 3,0±0,35 3,67±0,36 4,80±0,43 4,30±1,12 13 RV 6+SV1 RV 1+SV6 2,53±0,16 1,5±0,22 1,13±0,22 3,49±0,33 6,37±0,35 2,28±0,14* 14 RI/S1 -2,32±0,08 -3,26±0,88 -1,0±0,19 -1,94±0,12 -2,06±0,34 -1,30±0,18 15 RIII/S1II -3,14±0,13 -4,34±0,49 -1,68±0,54 -1,62±0,48 -1,20±0,11 -1,00±0,06 16 RVI/SV1 -0,64±0,09 -1,0±0,24 -0,35±0,10 -0,36±0,06 -0,70±0,06 -1,30±0,16 17 RV6/SV6 -4,51±0,14 -0,66±0,08 -1,79±0,72 -5,83±0,70* -3,65±0,87 -2,80±0,14 18 RVI/RV6 0,41±0,02 0,40±0,14* 0,22±0,04 0,25±0,02 0,33±0,05 0,16±0,08 19 (TV1)-(TV6) 3,23±0,08 0,51±0,11 2,33±0,88* 2,06±0,65* 1,20±0,33 2,75±0,12 20 (RV1)-(TV1) 5,78±0,18 1,75±0,52 1,33±0,33 1,33±0,42 2,60±0,32 3,00±0,15 21