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Discussion on pediatric exercise testing. Pediatric exercise testing may be used for evaluation of various disorders of cardiac rhythm rather than for inducible ischemia as in adults. In a child with suspected sinus node dysfunction, chronotropic incompetence from sinus node dysfunction can be assessed by exercise testing.
Treadmill Exercise ECG is usually done with a computerized treadmill unit which controls the motor speed of the treadmill as well as monitors the ECG. ECG is recorded periodically during the test in addition to documenting any specific events like arrhythmias. ECG recording in stage 1 of Bruce protocol of treadmill exercise test.
And right ventricular hypertrophy and the abnormal architecture of the right ventricle, can predispose to late arrhythmias and sudden cardiac death in repaired tetralogy of Fallot. That is why they need follow up for arrhythmias. Atrial arrhythmias are also common after TOF repair.
European Heart Rhythm Association (EHRA) Congress Date: April 7-9, 2024 Location: Berlin, Germany and online Overview: The yearly gathering of the European Heart Rhythm Association (EHRA) unites scientists, healthcare professionals, and other stakeholders engaged in the global management of arrhythmias.
This can be a source of cardiac arrhythmia as well. An important cause of arrhythmias in Ebstein’s anomaly is the presence of a right sided accessory atrioventricular pathway or WPW syndrome. A huge right atrium can also predispose to supraventricular arrhythmias in Ebstein’s anomaly.
During aerobic exercise which is isotonic, the heart rate and stroke volume increases. Isometric exercise or weight training on the other hand causes only slight increase in cardiac output due to increase in heart rate. Effect of exercise on right ventricle. J point elevation and early repolarization pattern has been reported.
Autonomic dysfunction caused by spinal cord injury is associated with abnormalities in blood pressure, heart rate variability, arrhythmias and blunted cardiovascular response to exercise which can limit the capacity to perform physical activity [1].
Angina is another common symptom due the hypertrophy which causes a coronary supply demand mismatch Symptoms of HCM include syncope/near syncope, which could be precipitated by exertion, hypovolemia, rapid standing, Valsalva manoeuvre, diuretics, vasodilators or arrhythmia. Palpitations can be felt if there are arrhythmias.
This is the proposed mechanism of precipitation of arrhythmias in Brugada syndrome during febrile episodes. There is a potential risk for drug challenge in that life threatening ventricular arrhythmias could be precipitated. This leads to shortening of action potential duration. With proper precautions, risk can be reduced.
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