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首页> 外文期刊>Progress in pediatric cardiology >Atrial flutter and fibrillation in the young patient without congenital heart disease
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Atrial flutter and fibrillation in the young patient without congenital heart disease

机译：没有先天性心脏病的年轻患者的房扑和房颤

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摘要

Atrial flutter and fibrillation are infrequently encountered in the young patient without congenital heart disease. Lone atrial flutter appears to be more common in boys and is most often present at birth. Cases diagnosed beyond the first week of life may present with tachycardia-induced cardiomyopathy, which typically resolves upon restoration of sinus rhythm. While antiarrhythmic drug therapy and catheter ablation may be indicated in some, most patients experience no recurrence on follow-up. Lone atrial fibrillation, though equally rare in children, typically presents in adolescence. In the absence of structural heart disease, atrial fibrillation in the young most frequently occurs in patients with Wolff-Parkinson-White syndrome or channelopathies, such as long and short QT and Brugada syndromes. Atrial fibrillation may also be triggered by acquired or iatrogenic conditions that result in atrial remodelling, inflammation, infiltration, and/or autonomic or neuro-hormonal imbalances. In the absence of pediatric evidence-based guidelines, management decisions regarding antiarrhythmic and anticoagulation therapy are largely inferred and adapted from the adult literature. Many questions remain unanswered, including thromboembolic risk estimates, pathophysiological mechanisms, potential associations with environmental factors such as competitive sports, and underlying genetic determinants.
机译：没有先天性心脏病的年轻患者很少发生房扑和房颤。孤独的房扑似乎在男孩中更为常见，并且最常见于出生时。在生命的第一周后诊断出的病例可能会出现心动过速引起的心肌病，通常可在窦性心律恢复后解决。尽管某些患者可能需要抗心律失常药物治疗和导管消融治疗，但大多数患者在随访中均未见复发。孤独性房颤虽然在儿童中同样少见，但通常在青春期出现。在没有结构性心脏病的情况下，年轻的心房颤动最常见于患有Wolff-Parkinson-White综合征或多发性QT和Brugada综合征等通道病的患者。心房颤动也可能由导致心房重构，炎症，浸润和/或自主神经或神经激素失衡的获得性或医源性条件触发。在没有儿科循证指南的情况下，有关抗心律失常和抗凝治疗的管理决策很大程度上是根据成人文献来推断和改编的。许多问题仍未解决，包括血栓栓塞风险评估，病理生理机制，与环境因素（如竞技体育）的潜在关联以及潜在的遗传决定因素。

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