Pediatric Exercise Testing

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. Evaluation of escape rates and ventricular ectopy with exercise in complete heart block is an important aspect in the evaluation of congenital complete heart block. ECG showing congenital complete heart block with ventricular rate of 47/min and atrial rate of 63/min. In stage I of Bruce protocol, the atrial rate has increased to 100/min and ventricular rate to 60/min. Tracing at peak exercise shows an atrial rate of 150/min and ventricular rate of 83/min. Increase in artefacts is visible on comparing the raw rhythm at the bottom of the image. Response of accessory pathway conduction to exercise gives useful information on the rate at which anterograde preexcitation is blocked. This measurement has been correlated with those made at electrophysiology study and may predict the potential risk of rapid anterograde conduction if the person develops atrial fibrillation. If the preexcitation disappears in response to exercise, it can be assumed that they have a relatively low risk for atrial fibrillation with very rapid ventricular rates due to preexcitation. QT prolongation and the occurrence of ventricular arrhythmias with exercise are another important aspect o...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs