title: Association of sinus node dysfunction, atrioventricular node conduction abnormality and ventricular arrhythmia in patients with Kawasaki disease and coronary involvement.
abstract: BACKGROUND
  This study was performed to investigate the incidence of arrhythmias in patients with Kawasaki disease (KD).
  
  
  RESULTS
  Electrophysiologic studies (EPS) were performed in 40 patients (mean age: 10.3+/-5.1 years; 30 males, 10 females) with KD who had severe to moderate coronary artery disease. Clinical arrhythmias were documented in 4 patients (premature ventricular contractions, ventricular tachycardia, atrioventricular block, and ventricular fibrillation). Dual atrioventricular nodal pathways were demonstrated in 3 patients. Nonsustained atrial fibrillation was induced in 1 patient. The AH interval was prolonged in 2 patients. The Wenckebach rate was 164+/-37 beats/min, and 4 of the patients had a decreased Wenckebach rate. The maximum and corrected sinus node recovery times were 997+/-257 ms and 281+/-130 ms, respectively, and 7 patients were thought to be abnormal. The sino-atrial conduction time was 108+/-64 ms, and 2 patients had prolonged conduction times.
  
  
  CONCLUSIONS
  Although there was no relationship between coronary stenosis or obstruction and the EPS parameters, the incidence of abnormal sinus node and atrioventricular node function is apparently higher in KD patients than in the normal population. These functional abnormalities may possibly be caused by myocarditis or an abnormal microcirculation in the sinus node and atrioventricular node artery. In some patients, myocardial ischemia may provoke malignant ventricular arrhythmia.
authors.affiliation: Department of Pediatrics and Pediatric Health, Nihon University School of Medicine, 30-1Oyaguchi Kamimachi, Itabashi-ku, Tokyo 173-8610, Japan. naokata@med.nihon-u.ac.jp
authors.forename: Naokata
authors.initials: N
authors.lastname: Sumitomo
authors.forename: Kensuke
authors.initials: K
authors.lastname: Karasawa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Rie
authors.initials: R
authors.lastname: Ichikawa
authors.forename: Junji
authors.initials: J
authors.lastname: Fukuhara
authors.forename: Osamu
authors.initials: O
authors.lastname: Abe
authors.forename: Michio
authors.initials: M
authors.lastname: Miyashita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kanamaru
authors.forename: Mamoru
authors.initials: M
authors.lastname: Ayusawa
authors.forename: Kensuke
authors.initials: K
authors.lastname: Harada
mesh_terms: D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000503:physiopathology; D054537:Atrioventricular Block / Q000209:etiology / Q000503:physiopathology; D001283:Atrioventricular Node / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000150:complications* / Q000503:physiopathology; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008833:Microcirculation / Q000503:physiopathology; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications* / Q000503:physiopathology