Cardiac Arrhythmias in Children with Sickle Cell Anaemia

Background : Sickle cell anaemia (SCA) is an important cause of morbidity and mortality in tropical Africa. Recurrent episodes of vaso-occlusive crisis often lead to organ ischaemia and/or infarction. Arrythmias are common and reliable manifestations of myocardial ischaemia and often follow infarction. The prevalence and pattern of cardiac arrhythmias among SCA patients has not been studied extensively, particularly in children. Objective: To determine whether or not, patients with SCA are more prone than others to cardiac arrhythmias. Patients and Methods: The standard 12-lead ECGs of 35 patients with SCA presenting during 40 episodes of vaso-occlusive crisis (Group A) were compared with those of 40 age- and sex-matched sicklers in the steady state (Group B) and with 40 age- and sex-matched patients with anaemia due to causes other than haemoglobinopathy (Group C). Results: Cardiac arrhythmias were detected in four (10 percent) of the crisis episodes in Group A patients compared to three (7.5 percent) of patients in Group B and only one (2.5 percent) of the patients in Group C (p>0.3). In Groups A and B, the arrhythmias were all of atrial origin. The mean haematocrit level of Group A subjects with arrhythmias was significantly lower than those without (p= 0.037). Conclusions: Although differences did not reach statistical significance, the results suggest that patients with SCA appear to be more prone to cardiac arrhythmias than others, whether or not they are in crisis. Further studies involving larger populations are indicated. Nigerian Journal of Paediatrics2003;30:13-1