Dikkat eksikliği ve hiperaktivite bozukluğu aritmi potansiyeli mi taşıyor?
Amaç: Dikkat eksikliği ve hiperaktivite bozukluğu (DEHB) genel pediatrik grupta oldukça sık görülmektedir. Bu grup- ta aritmi taşıyan sempatomimetik ilaçlar sıklıkla kullanılmaktadır. Bu çalışmada, ilaç kullanmayan DEHB hastaları ve kontrol grubunun EKG özellikleri karşılaştırıldı. Yöntem: Bu çalışmaya Kasım 2017 - Ocak 2018 tarihleri arasın- da çocuk ve ergen psikiyatrisi polikliniğine başvuran 43 ilaç kullanmayan DEHB’li ve 36 sağlıklı çocuk alındı. Hasta ve kontrol grubunun standart 12 derivasyonlu EKG’leri değerlendirildi. DEHB ve kontrol grubu minimum QT, maksi- mum QT intervalleri, düzeltilmiş QT (QTc), QT dispersiyonu (QTd), T pik-T son (Tp-e) süresi ve Tp-e dispersiyonu (Tp-ed) 12 derivasyonlu EKG’de hesaplanarak karşılaştırıldı. TP-e intervali teğet yöntemi ile ölçüldü. QT mesafesi düzeltilmesinde Bazett formülü kullanıldı. Bulgular: DEHB hastalarının yaş ortalaması 10.6±3.2 yıl ve %62.8’i erkek olup kontrol grubuyla benzer özellik göstermekteydi. Kalp hızı, min QT, max QT ve min Tp-e değerleri açısından DEHB ve kontrol grubu arasında anlamlı fark bulunmadı. QTc, QTd, max Tp-e ve Tp-ed süreleri DEHB grubunda kontrol grubuna göre anlamlı olarak yüksek bulundu. Sonuç: QT dispersiyonu ve Tp-e repolarizasyonun transmural dağılımının ölçütü olup kardiyak aritmilerle ilişkilidir. DEHB hastalarında yüksek QTd, QTc, max Tp-e ve Tp-ed süreleri kardiyak aritmi riskini gösterebilir. Klinisyenler, DEHB hastalarına sempatomimetik ilaç yazmadan önce dikkatli değerlendirme yapmalıdır. (Anadolu Psikiyatri Derg 2018; 19(6):624-630)
Does attention deficit hyperactivity disorder have cardiac arrhythmia potential?
Objective: Attention deficit hyperactivity disorder (ADHD) is quite common in the general pediatric population. Inthis population, sympathomimetic drugs, which are at risk of arrhythmia, are frequently used. In this study, ECGcharacteristics of drug naive ADHD patients were compared control group. Methods: This study was performed 43drug naive ADHD patients and 36 healthy children who admitted to the child and adolescent psychiatry outpatientclinic between November 2017 and January 2018. A standard 12-lead ECG of the patient and control group wereevaluated. The ADHD and control group data were compared by calculating the minimum and maximum QT inter-val, corrected QT (QTc), QT dispersion (QTd), the peak and the end of the T wave (Tp-e) and Tp-e dispersion (Tp-ed) on 12-lead surface ECG. Tp-e interval was measured tangent method. The Bazett formula was used for QTcorrection. Results: The mean age of the patients with ADHD was 10.6±3.2 and 62.8% of them were male andsimilar to the control group. There was no significant difference between ADHD and control groups in terms of heartrate, min QT, max QT and min Tp-e values. QTc, QTd, max Tp-e and Tp-ed intervals were statistically higher ADHDpatients than control group. Conclusion: QT dispersion and Tp–e is a measure of transmural dispersion of repolari-zation and related to cardiac arrhythmias. High QTd, QTc, max Tp-e and Tp-ed intervals in ADHD patients mayindicate a potential cardiac arrhythmia. Physicians should make careful assessments of ADHD patients before pre-scribing sympathomimetic drugs. (Anatolian Journal of Psychiatry 2018; 19(6):624-630)
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