21. Một số yếu tố liên quan đến rối loạn nhịp tim trong viêm cơ tim cấp ở trẻ em

Abstract

Cardiac arrhythmias are common complications in children with acute myocarditis. Some types of arrhythmias are often associated with severe clinical illness, including potential death. A cross-sectional descriptive study was conducted to assess the prevalence of arrhythmias and analyze factors related to arrhythmias occurring in children with acute myocarditis diagnosed and treated in the National Children's Hospital over a 5-year period from 2018 - 2023. Among the 118 children diagnosed with acute myocarditis, males accounted for 49.2%, with the male: female ratio ≈ 1:1. The average age was 8.1 ± 4.8 years old (range: 12 days old to 18 years old). The majority (72.0%) was over 6 years old. The overall rate of arrhythmia was 46.6%, and was more frequently observed in girls (61.8%). The most common arrhythmias were ventricular tachycardia (58.2%) and third-degree atrioventricular block (47.3%), while multifocal atrial tachycardia (1.8%) and junctional rhythm (1.8%) were rare. On average, arrhythmia occurred 3.4 ± 1.2 days into the course of the disease. The proportion of patients with one type of arrhythmia was 56.4% (31/55 patients), two types of arrhythmia was 23.6%, and three type of arrhythmia was 20.0%. Multivariate regression analysis identified ECG changes including ST elevation and low voltage, hyperlactatemia, hypokalemia were independent risk factors for the occurrence of arrhythmias in children with acute myocarditis.