Association of sinus node dysfunction, atrioventricular node conduction abnormality and ventricular arrhythmia in patients with Kawasaki disease and coronary involvement.
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.
Sumitomo
Naokata
N
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
Karasawa
Kensuke
K
Taniguchi
Kazuo
K
Ichikawa
Rie
R
Fukuhara
Junji
J
Abe
Osamu
O
Miyashita
Michio
M
Kanamaru
Hiroshi
H
Ayusawa
Mamoru
M
Harada
Kensuke
K
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