THE STATE OF THE AUTONOMIC NERVOUS SYSTEM IN CHILDREN WITH EXTRASYSTOLIC ARRHYTHMIAS

Abstract

Cardiovascular pathology in children is actual problem nowdays. In particular, heart rhythm disturbances play important role as the trigger factor of serious complications, including sudden cardiac death. Cardiac arrhythmias in children play important medical and social role nowadays. Literature data emphasize the possible relationship between the appearance of extrasystolic arrhythmias and autonomic nervous system imbalance. Purpose of study is to assess the autonomic nervous system condition in children with different types of extrasystolic cardiac arrhythmias. Materials and methods. 88 children with extrasystolic cardiac arrhythmias were examined. They were divided into three subgroups, which included 40 (45,5%) children with supraventricular extrasystoles, 28 (31,8%) with ventricular and 20 (22,7%) with polytopic, respectively. The control group consisted of 22 almost healthy children. The condition of autonomic nervous system was assessed by using the cardiointervalography (CIG), clinoorthostatic test and heart rate variability (time domain) by Holter ECG monitoring. Results. In children with extrasystolic arrhythmias, the level of functioning of the autonomic nervous system according to CIG data was characterized mainly by sympathicotonia (55,7%), amphotonia (33,0%), and parasympathicotonia (11.4%). An imbalance of autonomic homeostasis with predominance of sympathetic part was established. Thus, a decrease in SDNN, SDANN-i and SDNN-i parameters were noted. SDNN-i was decreased with a statistically significant difference (p<0,05) in all children of the main group compared to the control data. In addition, it was mentioned that the decrease in these parameters data was associated with the severity of extrasystoles. In all children, the hypersympathicotonic type of clinoortho test was present in the majority of children (65,9%). Conclusions. In all children with extrasystolic arrhythmias, an imbalance of autonomic nervous system lines was mentioned with the prevalence of sympathetic part. The imbalance level of autonomic homeostasis increases with the severity of extrasystolic arrhythmias. All children with detected arrhythmias should undergo to autonomic nervous system examination in order to identify, prevent and correct possible changes.