Long-term outcome of neonates and infants with permanent junctional reciprocating tachycardia. When cardiac ablation changes natural history

Barbero, Ana Herranz; César, Sergi; Martínez‐Osorio, Johanna; Margarit, A. S.; Moreno, Javier; Campuzano, Óscar; Iglesias-Platas, Isabel; Brugada, Josép; Sarquella‐Brugada, Georgia

doi:10.1016/j.jelectrocard.2019.05.006

Cited by 10 publications

(11 citation statements)

References 19 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[3][4][5] A left lateral location of the decremental AP is uncommon, especially in children. [6][7][8] In our case, eccentric retrograde atrial activation on coronary sinus electrograms was evident, supporting diagnosis of an atypically located decremental AP in the left lateral mitral annulus. Careful observation on the intracardiac electrograms of the behavior of the arrhythmia during the occurrence of PVCs confirmed our diagnosis.…”

supporting

confidence: 75%

“…APs with decremental conduction properties that sustain PJRT are usually located in or near the CS ostium, 2 but atypical locations are also reported 3–5 . A left lateral location of the decremental AP is uncommon, especially in children 6–8 . In our case, eccentric retrograde atrial activation on coronary sinus electrograms was evident, supporting diagnosis of an atypically located decremental AP in the left lateral mitral annulus.…”

Section: Commentarysupporting

confidence: 62%

See 1 more Smart Citation

Nearly incessant supraventricular tachycardia in a child diagnosed without pacing maneuvers: What's the mechanism?

Ciriello,

Colonna,

Correra

et al. 2023

Pacing Clinical Electrophis

View full text Add to dashboard Cite

An 11-year-old boy with almost incessant supraventricular tachycardia (SVT) without any structural heart disease was referred to our Unit for electrophysiologic (EP) study and catheter ablation (CA). He was on therapy with Sotalol that was stopped 5 days before the admission.EP study was performed under general anesthesia. We used a nearzero fluoroscopic approach guided by electroanatomic mapping (EAM), according to our typical workflow for CA in children. At EP study, we observed that spontaneous and/or mechanical premature ventricular contractions (PVC) easily induced a narrow QRS tachycardia with slow tachycardia cycle length (TCL ∼ 430 ms), long ventriculoatrial (VA) interval and eccentric 1:1 retrograde atrial activation. Spontaneous induction and spontaneous interruption with no retroconduction by single PVCs was noted (Figure 1). Furthermore, a left-sided PVC occurring spontaneously when the His bundle was refractory (−20 ms) interrupted the arrhythmia with no retroconduction (Figure 2). At this point, what could be the most likely mechanism of the tachycardia without carrying out any pacing maneuvers? COMMENTARYPermanent junctional reciprocating tachycardia (PJRT) is a rare SVT in infants and children.

show abstract

supporting

confidence: 75%

Section: Commentarysupporting

confidence: 62%

Nearly incessant supraventricular tachycardia in a child diagnosed without pacing maneuvers: What's the mechanism?

Ciriello,

Colonna,

Correra

et al. 2023

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

“…Although PJRT can be found at any age, beginning in the fetal period, the majority of research and case reports in the children's age range are under the age of 1 year. 8 - 11 However, there have been studies conducted on adults. The mean age in our study was found to be greater than in other pediatric age group studies.…”

Section: Discussionmentioning

confidence: 99%

“…While the ablation success rate in the pediatric age group was reported to be 77%-96.4 %, the acute procedure success rate in our patients was 100%. 2 , 5 , 8 , 9 There have been reports of complication rates ranging from 2% to 12%. Despite the fact that the ablation age in our study was lower than that reported in other studies, no complications were observed in any of our patients, and the acute success rate was also high.…”

Section: Discussionmentioning

confidence: 99%

Clinical Course and Electrophysiological Characteristics of Permanent Junctional Reciprocating Tachycardia in Children

Ergül

Sülü

Çaran

et al. 2022

The Anatolian Journal of Cardiology

View full text Add to dashboard Cite

Background: In this study, we aimed to evaluate the clinical aspects, electrophysiological studies, and ablation results of permanent junctional reciprocating tachycardia in children. Methods: The study comprised 29 pediatric patients diagnosed with permanent junctional reciprocating tachycardia between 2011 and 2021 in 2 pediatric electrophysiology centers. From the file records, the basic demographic characteristics of the patients, as well as electrocardiographic and echocardiographic findings, were acquired retrospectively. The medical treatment and responses of the patients throughout follow-up, as well as the electrophysiological study and ablation data of the patients who had electrophysiological study, were assessed. Results: The mean age at diagnosis of the patients was 3.13 ± 4.43 (0-18) years and the mean weight was 18.22 ± 19.68 (3.8-94) kg. Eighteen patients (62.1%) were girls. Eleven patients (38%) developed tachycardia-induced cardiomyopathy. Tachycardia was incessant in 15 patients (51.7%). In total, 22 patients required 26 ablation procedures. Tachycardia-induced cardiomyopathy and multidrug-resistant tachycardia were the most prevalent indications for ablation. The right posteroseptal pathway was detected in 18 patients (81.8%). The acute procedure success rate was 100% (22/22). The recurrence rate was 18% (4/22) and 3 of them underwent successful ablation again. The overall success percentage was 95.4% (21/22). None of the patients had any complications. The mean follow-up period was 4.39 ± 3.05 years. Conclusion: Although permanent junctional reciprocating tachycardia is uncommon, it is often persistent, resistant to medical treatment, and associated with a substantial risk of tachycardia-induced cardiomyopathy. Catheter ablation can be performed on these patients at any age, with minimal risk of complications and a high success rate. It is crucial to keep monitor of the patients’ recurrence.

show abstract

“…Persistent junctional reciprocating tachycardia (PJRT) is known to cause such a clinical presentation. [ 1 ] Decremental conduction in the accessory pathway (AP) creates the ideal conditions for an ongoing tachycardia that is often resistant to medical treatment. Especially in infants, due to the physiological differences of the developing circulatory system, delayed diagnosis of the supraventricular tachycardia (SVT) leads to exhaustion of the compensatory mechanisms and dependency of the cardiac output on the high heart rate (HR).…”

Section: Introductionmentioning

confidence: 99%

Intracardiac atrial overdrive pacing as an alternative to extracorporeal membrane oxygenation in the treatment of cardiogenic shock due to drug refractory and incessant persistent junctional reciprocating tachycardia in a 7-month-old infant

Książczyk

Pietrzak

Werner

2021

Annals of Pediatric Cardiology

View full text Add to dashboard Cite

In the case of prolonged, undiagnosed persistent junctional reciprocating tachycardia in infants, compensatory mechanisms are exhausted leading to heart failure. However, when cardioverted to sinus rhythm patients often deteriorate due to cardiac output dependency on the higher rates. Extracorporeal membrane oxygenation (ECMO) is often used to stabilize their hemodynamic status. A 7-month-old female infant was admitted in cardiogenic shock due to drug refractory supraventricular tachycardia (SVT). Pharmacological cardioversion to sinus rhythm with heart rate (HR) of 90 bpm was achieved but resulted in hemodynamic deterioration and early recurrence of arrhythmia. Right atrial overdrive pacing (ODP) wire was introduced through femoral vein and allowed to override the tachycardia with 2:1 A:V block and HR of 160 bpm. ODP was continued for 24 h allowing to wean off the inotropic support. We postulate that ODP can be a safe and less invasive alternative to ECMO in stabilizing infants with cardiogenic shock due to intractable SVTs.

show abstract

Long-term outcome of neonates and infants with permanent junctional reciprocating tachycardia. When cardiac ablation changes natural history

Cited by 10 publications

References 19 publications

Nearly incessant supraventricular tachycardia in a child diagnosed without pacing maneuvers: What's the mechanism?

Nearly incessant supraventricular tachycardia in a child diagnosed without pacing maneuvers: What's the mechanism?

Clinical Course and Electrophysiological Characteristics of Permanent Junctional Reciprocating Tachycardia in Children

Intracardiac atrial overdrive pacing as an alternative to extracorporeal membrane oxygenation in the treatment of cardiogenic shock due to drug refractory and incessant persistent junctional reciprocating tachycardia in a 7-month-old infant

Contact Info

Product

Resources

About