Clinical Implication of Multifocal Atrial Tachycardia in Children for Pediatric Cardiologist

Huh, June

doi:10.4070/kcj.2018.0037

Cited by 3 publications

(4 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most cases of MAT have been detected in infancy and utero, which suggests that immaturity and vulnerability of the atrial cells are responsible for the infantile-dominated distribution of MAT ( 4 ). During pregnancy, many risk factors, such as gestational hypertension and diabetes, result in fetal ischemia, hypoxia, and edema, inducing abnormal development of fetal atrial tissue, cells, and epicardial adipose tissue ( 9 ), which in turn results in fetal atrial development abnormalities and changes in signal transduction and contributes to MAT.…”

Section: Etiology Of Mat At Different Periods Of Growthmentioning

confidence: 99%

“…Multifocal atrial tachycardia (MAT) is defined as the presence of 3 or more P wave morphologies, which is characterized by irregular P-P, R-R, and P-R intervals, isoelectric baseline between the P waves, and ventricular rate over 100 beats/min on the electrocardiogram (1)(2)(3)(4). MAT accounts for less than 1% of supraventricular tachycardia in pediatric arrhythmia, and 82% of patients diagnosed with MAT in infancy, whose lungs and heart are both immature (3,5,6).…”

Section: Introductionmentioning

confidence: 99%

“…The adverse outcomes of MAT include cardiogenic death (3%), respiratory failure (6%), or persistent arrhythmia (7%). Some recent studies demonstrated that pediatric MAT is associated with multiple enhanced automatic lesions located in the atrium or abnormal automaticity of a single lesion located in the pulmonary veins via multiple pathways to trigger electrical activity ( 4 ). However, the pathophysiology of pediatric MAT is needed to be further explored, which needs to further analyze more clinical interrelated information and conduct fundamental experiment studies ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Progress of Pathogenesis in Pediatric Multifocal Atrial Tachycardia

Chen

Wang

et al. 2022

Front. Pediatr.

View full text Add to dashboard Cite

Multifocal atrial tachycardia (MAT) is defined as irregular P-P, R-R, and P-R intervals, isoelectric baseline between P waves, and ventricular rate over 100 beats/min. Although the prognosis of pediatric MAT in most patients is favorable, adverse outcomes of MAT have been reported, such as cardiogenic death (3%), respiratory failure (6%), or persistent arrhythmia (7%), due to delayed diagnosis and poorly controlled MAT. Previous studies demonstrated that pediatric MAT is associated with multiple enhanced automatic lesions located in the atrium or abnormal automaticity of a single lesion located in the pulmonary veins via multiple pathways to trigger electrical activity. Recent studies indicated that pediatric MAT is associated with the formation of a re-entry loop, abnormal automaticity, and triggering activity. The occurrence of pediatric MAT is affected by gestational disease, congenital heart disease, post-cardiac surgery, pulmonary hypertension, and infectious diseases, which promote MAT via inflammation, redistribution of the autonomic nervous system, and abnormal ion channels. However, the pathogenesis of MAT needs to be explored. This review is aimed to summarize and analyze the pathogenesis in pediatric MAT.

show abstract

Section: Etiology Of Mat At Different Periods Of Growthmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Progress of Pathogenesis in Pediatric Multifocal Atrial Tachycardia

Chen

Wang

et al. 2022

Front. Pediatr.

View full text Add to dashboard Cite

show abstract

“…Ectopic multifocal atrial tachycardia is the arrhythmia characterized by the presence of P waves with three or more morphologies, namely irregular P-P, P-R, and R-R intervals; and the isoelectric line between P waves, with heart rate above the 98th percentile for age (Figure 5). Stimuli have different origins in ectopic atrial foci [45]. The QRS complex is narrow, and a warm-up pattern is observed (progressive atrial frequency increase).…”

Section: Ectopic Atrial Tachycardiamentioning

confidence: 99%

Postoperative Cardiac Arrhythmias in Pediatric and Neonatal Patients with Congenital Heart Disease—A Narrative Review

Ganea,

Cinteză,

Filip

et al. 2023

Life

View full text Add to dashboard Cite

Cardiac arrhythmias are a frequent complication in the evolution of patients with congenital heart disease. Corrective surgery for these malformations is an additional predisposition to the appearance of arrhythmias. Several factors related to the patient, as well as to the therapeutic management, are involved in the etiopathogenesis of cardiac arrhythmias occurring post-operatively. The risk of arrhythmias in the immediate postoperative period is correlated with the patient’s young age and low weight at surgery. The change in heart geometry, hemodynamic stress, and post-surgical scars represent the main etiopathogenic factors that can contribute to the occurrence of cardiac arrhythmias in the population of patients with operated-on congenital heart malformations. Clinical manifestations differ depending on the duration of the arrhythmia, underlying structural defects, hemodynamic conditions, and comorbidities. The accurate diagnosis and the establishment of specific management options strongly influence the morbidity and mortality associated with arrhythmias. As such, identifying the risk factors for the occurrence of cardiac arrhythmias in the case of each patient is essential to establish a specific follow-up and management plan to improve the life expectancy and quality of life of children.

show abstract

Experience in the management of infants with multifocal atrial tachycardia

Kovalchuk

Кручина

Tatarskiy

et al. 2021

Vestnik aritmologii

View full text Add to dashboard Cite

Purpose. To study the clinical course of multifocal atrial tachycardia (MAT) and to evaluate the effectiveness of antiarrhythmic therapy (AAT) in patients with onset of arrhythmia before the age of 1 year.Methods. The study included 15 children with primary registration of MAT at the age of 2.04±2.27 months, 4 of them - in utero. The follow-up period was 35.9±26.9 months (Me 29 months). All patients underwent laboratory monitoring, 12-lead ECG recording, 24-hour ECG monitoring, echocardiography at baseline and during time of observation.Results. Tachycardia was persistent in 80% of patients. Tachycardia-induced cardiomyopathy (TIC) was present in 7 (46%) patients. Structural heart disease was detected in 6 patients. The average heart rate at the onset of the disease was 157.9±23.78 bpm, the maximum - 256.7±35.84 bpm. Fourteen (93.3%) children received AAT. Seven patients were prescribed propranolol first, 6 - amiodarone, 1 - digoxin. Monotherapy was effective in 2 patients. Combined AAT was used in 12 patients, including three children with three drugs combination. No benefits were found for any of the drugs combinations. Stable sinus rhythm at the time of discharge was observed in 4 (28,6%) patients, sinus rhythm with atrial ectopic activity was registered in 2 of them; criteria for normosystole were achieved in 7 patients; in one child with TIC daytime tachysystole persisted despite three-component AAT, but echocardiography parameters improved. Arrhythmia was disappeared in 13 (86.6%) patients; the duration of arrhythmia in them from 1 to 15 months, duration of AAT - 1 ±7.5 months (Me 9.5 months). MAT persists in two patients with structural heart disease. One patient underwent radiofrequency ablation at the age of 5, with no effect. One patient had side effects from therapy that required correction. There were no lethal outcomes.Conclusion. MAT with a debut at the age of 1 year with timely prescribed treatment has a favorable course and a good prognosis, but the probability of AAT resistance is high. These cases require a long-term selection of therapy using various combinations of antiarrhythmic drugs. Heart rate control strategy can be sufficient to prevent the development of TIC.

show abstract

Clinical Implication of Multifocal Atrial Tachycardia in Children for Pediatric Cardiologist

Cited by 3 publications

References 9 publications

Progress of Pathogenesis in Pediatric Multifocal Atrial Tachycardia

Progress of Pathogenesis in Pediatric Multifocal Atrial Tachycardia

Postoperative Cardiac Arrhythmias in Pediatric and Neonatal Patients with Congenital Heart Disease—A Narrative Review

Experience in the management of infants with multifocal atrial tachycardia

Contact Info

Product

Resources

About