tetano
Editor, Senior Moderator
Pediatrics
. 2020 Nov 12;e2020009738.
doi: 10.1542/peds.2020-009738. Online ahead of print.
MIS-C and Cardiac Conduction Abnormalities
Nak Hyun Choi[SUP] 1 [/SUP], Michael Fremed[SUP] 1 [/SUP], Thomas Starc[SUP] 1 [/SUP], Rachel Weller[SUP] 1 [/SUP], Eva Cheung[SUP] 1 [/SUP], Anne Ferris[SUP] 1 [/SUP], Eric S Silver[SUP] 1 [/SUP], Leonardo Liberman[SUP] 2 [/SUP]
Affiliations
Abstract
Objectives: Multisystem inflammatory syndrome in children (MIS-C) has spread through the pediatric population during the coronavirus disease 2019 pandemic. Our objective for the study was to report the prevalence of conduction anomalies in MIS-C and identify predictive factors for the conduction abnormalities.
Methods: We performed a single-center retrospective cohort study of pediatric patients <21 years of age presenting with MIS-C over a 1-month period. We collected clinical outcomes, laboratory findings, and diagnostic studies, including serial electrocardiograms, in all patients with MIS-C to identify those with first-degree atrioventricular block (AVB) during the acute phase and assess for predictive factors.
Results: Thirty-two patients met inclusion criteria. Median age at admission was 9 years. Six of 32 patients (19%) were found to have first-degree AVB, with a median longest PR interval of 225 milliseconds (interquartile range 200-302), compared with 140 milliseconds (interquartile range 80-178) in patients without first-degree AVB. The onset of AVB occurred at a median of 8 days after the initial symptoms and returned to normal 3 days thereafter. No patients developed advanced AVB, although 1 patient developed a PR interval >300 milliseconds. Another patient developed new-onset right bundle branch block, which resolved during hospitalization. Cardiac enzymes, inflammatory markers, and cardiac function were not associated with AVB development.
Conclusions: In our population, there is a 19% prevalence of first-degree AVB in patients with MIS-C. All patients with a prolonged PR interval recovered without progression to high-degree AVB. Patients admitted with MIS-C require close electrocardiogram monitoring during the acute phase.
. 2020 Nov 12;e2020009738.
doi: 10.1542/peds.2020-009738. Online ahead of print.
MIS-C and Cardiac Conduction Abnormalities
Nak Hyun Choi[SUP] 1 [/SUP], Michael Fremed[SUP] 1 [/SUP], Thomas Starc[SUP] 1 [/SUP], Rachel Weller[SUP] 1 [/SUP], Eva Cheung[SUP] 1 [/SUP], Anne Ferris[SUP] 1 [/SUP], Eric S Silver[SUP] 1 [/SUP], Leonardo Liberman[SUP] 2 [/SUP]
Affiliations
- PMID: 33184170
- DOI: 10.1542/peds.2020-009738
Abstract
Objectives: Multisystem inflammatory syndrome in children (MIS-C) has spread through the pediatric population during the coronavirus disease 2019 pandemic. Our objective for the study was to report the prevalence of conduction anomalies in MIS-C and identify predictive factors for the conduction abnormalities.
Methods: We performed a single-center retrospective cohort study of pediatric patients <21 years of age presenting with MIS-C over a 1-month period. We collected clinical outcomes, laboratory findings, and diagnostic studies, including serial electrocardiograms, in all patients with MIS-C to identify those with first-degree atrioventricular block (AVB) during the acute phase and assess for predictive factors.
Results: Thirty-two patients met inclusion criteria. Median age at admission was 9 years. Six of 32 patients (19%) were found to have first-degree AVB, with a median longest PR interval of 225 milliseconds (interquartile range 200-302), compared with 140 milliseconds (interquartile range 80-178) in patients without first-degree AVB. The onset of AVB occurred at a median of 8 days after the initial symptoms and returned to normal 3 days thereafter. No patients developed advanced AVB, although 1 patient developed a PR interval >300 milliseconds. Another patient developed new-onset right bundle branch block, which resolved during hospitalization. Cardiac enzymes, inflammatory markers, and cardiac function were not associated with AVB development.
Conclusions: In our population, there is a 19% prevalence of first-degree AVB in patients with MIS-C. All patients with a prolonged PR interval recovered without progression to high-degree AVB. Patients admitted with MIS-C require close electrocardiogram monitoring during the acute phase.