目的 探讨儿童心动过速性心肌病（TIC）的临床特点,治疗及预后。方法 回顾分析2013年1月至2020年9月住院治疗的18例TIC患儿的临床资料,并进行随访。选取同时期住院扩张型心肌病（DCM）患儿40例,比较TIC组和DCM组临床特点、治疗情况及预后。结果 TIC组18例患儿中,心律失常类型以房性心动过速（简称房速）为主（15例,83.3%）。15例房速中,8例为持续无休止性房速。中重度左心收缩功能下降者（n=7）心律失常占总心率百分比为100%（91.9%~100%）,轻度下降者（n=7）为38.7%（32.9%~99.8%）,差异有统计学意义（P<0.05）。18例患儿均首先予以药物治疗,6例药物复律后维持窦性心律,12例药物转复后不能维持窦性心律者中7例行射频消融术,均成功复律,其余5例予药物控制心律及心室率,心室率明显下降,心律失常发作频率及负荷明显降低。与DCM组相比,TIC患儿诊断年龄较小,急性期心率较快,急性期HR指数较大、心功能Ⅲ~Ⅳ级发生比例较低,首次就诊时经体表面积标准化后的左心室舒张末期内径Z值（LVEDD-Z）较小,左心室射血分数（LVEF）、左室短轴缩短率（LVFS）较高,房速比例较高,室速比例较低,24小时动态心电图总心率较高,心律失常占总心率百分比较高,治疗2周内血B型利钠肽（BNP）水平升高的比例较低,治疗前BNP与治疗后2周内BNP的比值（BNP-R）较大,差异均有统计学意义（P<0.05）。结论 心动过速显著,异位节律心动过速负荷高,同时合并左心收缩功能受损及心脏扩大,复律或控制心室率后受损左心收缩功能恢复快且完全,心脏扩大恢复明显需多考虑TIC诊断。TIC患儿总体预后较好。

Objective To investigate the clinical features, treatment and prognosis of tachycardia-induced cardiomyopathy (TIC) in children. Methods The clinical data of 18 hospitalized children with TIC from January 2013 to September 2020 were retrospectively analyzed and the patients were followed up. Forty children with dilated cardiomyopathy (DCM) were selected at the same time. The clinical characteristics, treatment and prognosis between TIC and DCM groups were compared. Results Among 18 children with TIC, 15 (83.3%) had atrial tachycardia and among the 15 children, 8 were persistent atrial tachycardia. The percentage of arrhythmia in total heart rate was 100% (91.9% -100%) in patients with moderate to severe left ventricular systolic function decline (n=7), and 38.7% (32.9% -99.8%) in patients with mild left ventricular systolic function decline (n=7), and the difference was statistically significant (P<0.05). All 18 patients were given drug therapy at first, 6 patients maintained sinus rhythm after drug cardioversion, and 7 of the 12 patients who could not maintain sinus rhythm after drug cardioversion underwent radiofrequency ablation, and all patients succeeded in cardioversion. The other 5 patients were given drugs to control heart rhythm and ventricular rates, and the ventricular rates decreased obviously, and the frequency and load of arrhythmia decreased significantly. Compared with the DCM group, the children in the TIC group was diagnosed at a younger age, had a faster heart rate and a larger heart rate index in the acute phase, a less frequent occurrence of moderate-to-severe heart failure, a smaller left ventricular end-diastolic dimension Z value (LVEDD-Z) after normalized body surface area at the first visit, a higher left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS), a higher percentage of atrial tachycardia, a lower ratio of ventricular tachycardia, a higher total heart rate in 24h-dynamic electrocardiogram, a higher arrhythmias percentage of total heart rate, a lower ratio of serum B-type natriuretic peptide (BNP) increase within 2 weeks of treatment, and a higher ratio of BNP before treatment to BNP within two weeks after treatment (BNP-R), and the differences were significant (P<0.05). Conclusions If the heart rate of the child increases significantly, the load of ectopic rhythm tachycardia is high, and there is impaired left ventricular systolic function and cardiac enlargement at the same time, and after cardioversion treatment or control of ventricular rate by medication, the impaired left ventricular systolic function recovers quickly and completely, and the enlarged heart shrinks significantly, the diagnosis of TIC should be considered. The overall prognosis of TIC is good.