Amiodarone management of junctional ectopic tachycardia after cardiac surgery in children.

Abstract

Objective-To assess the effectiveness and safety of amiodarone in the treatment of junctional ectopic tachycardia (JET) after open heart surgery in children. Patients-Between January 1990 and December 1991, 16 consecutive patients aged 6 days to 14 years with JET associated with significant haemodynamic impairment after cardiopulmonary bypass were treated with amiodarone as the principal antiarrhythmic drug. Interventions-Amiodarone 5 mglkg was administered intravenously over one hour and the same dose was subsequently infused over 12 hours. This was reviewed every 12 hours and repeated as necessary until a satisfactory heart rate and stable haemodynamics were achieved. Atrial pacing was used whenever possible to provide atrioventricular synchrony. Results-Except for one patient with a JET rate of 160/min, the maximum JET rate ranged from 180/min to 245/min with a mean(SD) of 200 (20)

Congenital junctional ectopic tachycardia in children and adolescents: a 20 year experience based study

“…1 Despite the excellent results presented in previous work, 5 in our series propafenone, used alone, resulted in effectively preventing or controlling tachycardia in three patients only, especially in those patients with lower heart rate (mean rate during tachycardia 170 bpm). According to a previous report, 6 amiodarone was substantially successful within the first five days of treatment, without any complications during follow up. Furthermore, we noted that the combination of amiodarone and a Ic antiarrhythmic drug could be used to reduce the dose of amiodarone, with excellent results.…”

Junctional ectopic tachycardia in six paediatric patients

“…Amiodarone is reportedly one of the more effective agents used to treat patients with both congenital and postoperative forms of JET,3 8 9 but its alleged side effects limit its chronic use 10. Fortunately, toxic effects appear to be rare in children younger than 10 years old 11.…”

Postoperative narrow complex tachycardia presenting with low cardiac output

“…JET is unresponsive to DC cardioversion 2. Amiodarone is the antiarrhythmic of choice and helps in lowering the rate 3. Other drugs used in management include propafenone, flecainide and digoxin.…”