Successful management of junctional tachycardia by hypothermia after cardiac operations in infants

Pfammatter, Jean‐Pierre; Paul, Thomas; Ziemer, Gerhard; Kallfelz, H. C.

doi:10.1016/0003-4975(95)00425-k

Cited by 74 publications

(39 citation statements)

References 14 publications

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“…Small observational studies support the use of ibutilide or intravenous procainamide for the treatment of pre-excited AF in patients who are not hemodynamically compromised. 264,265 Both medications can decrease ventricular rate by slowing conduction over the accessory pathway and have the additional benefit of possibly terminating AF. Intravenous diltiazem or verapamil effectively terminate approximately 90% to 95% of AVRT episodes in patients without pre-excitation on their resting sinus-rhythm ECG, with drug-induced hypotension occurring in approximately 3% of patients.…”

Section: 94mentioning

confidence: 99%

“…475 Arrhythmias still can be treated successfully when they develop later after surgical corrections; catheter ablation of atrial arrhythmias associated with ASD repair is highly successful, with acute success rates reported as 93% to 100%. 449,458,477 Therefore, patients with unoperated significant ASD and arrhythmias should undergo ablation of the AT, as well as closure of the ASD. The choice of catheter versus surgical approaches to therapy is determined by anatomic features of the ASD likely to be successfully addressed with a catheter approach.…”

Section: 29mentioning

confidence: 99%

See 1 more Smart Citation

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

Page¹,

Joglar²,

Caldwell³

et al. 2016

Circulation

337

127

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Section: 94mentioning

confidence: 99%

Section: 29mentioning

confidence: 99%

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

Page¹,

Joglar²,

Caldwell³

et al. 2016

Circulation

337

127

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“…On the other hand, myocardial cooling has also been used to modify different cardiac rhythm disturbances. Thus descriptions have been made of the protective effect of mild hypothermia on ventricular arrhythmias in experimental models (9), and myocardial cooling has been used to terminate reentrant arrhythmias induced in isolated atrial preparations (26), to shorten mean atrial fibrillatory cycle length in Langendorff-perfused rabbit hearts (8), and for the management of supraventricular arrhythmias after heart surgery (11,22).…”

mentioning

confidence: 99%

Effects of acute reduction of temperature on ventricular fibrillation activation patterns

Chorro

Guerrero²,

Ferrero

et al. 2002

American Journal of Physiology-Heart and Circulatory Physiology

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Because of its electrophysiological effects, hypothermia can influence the mechanisms that intervene in the sustaining of ventricular fibrillation. We hypothesized that a rapid and profound reduction of myocardial temperature impedes the maintenance of ventricular fibrillation, leading to termination of the arrhythmia. High-resolution epicardial mapping ( series 1; n = 11) and transmural recordings of ventricular activation ( series 2; n = 10) were used to analyze ventricular fibrillation modification during rapid myocardial cooling in Langendorff-perfused rabbit hearts. Myocardial cooling was produced by the injection of cold Tyrode into the left ventricle after induction of ventricular fibrillation. Temperature and ventricular fibrillation dominant frequency decay fit an exponential model to arrhythmia termination in all experiments, and both parameters were significantly correlated ( r = 0.70, P < 0.0001). Termination of the arrhythmia occurred preferentially in the left ventricle and was associated with a reduction in conduction velocity (−60% in left ventricle and −54% in right ventricle; P < 0.0001) and with activation maps predominantly exhibiting a single wave front, with evidence of wave front extinction. We conclude that a rapid reduction of temperature to <20°C terminates ventricular fibrillation after producing an important depression in myocardial conduction.

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“…Intensive care characteristically includes surface cooling, atrial pacing, and antiarrhythmic rate-control therapy (3,6). Although catecholamines may worsen the tachyarrhythmia, such inotropes are commonly used to support the circulation.…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary Bypass Surgery in Children - Minimizing the Incidence of Postoperative Junctional Ectopic Tachycardia after Surgical Technique Modification

Azhar¹,

Arabia²

2012

Am. J. Biomed. Sci.

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Background: Mechanical injury to tissues in and surrounding the Atrioventricular node is considered a major factor in the aetiology of postoperative Junctional Ectopic Tachycardia (JET).Objectives: The study aims to evaluate the effect of retractor modification used during cardiopulmonary bypass surgery and the incidence of postoperative JET in children.Material & Methods: The study involves retrospective chart review of all pediatric patients who had undergone cardiopulmonary bypass surgery in Children Hospital of Eastern Ontario, Canada, between 1993 and 1996. Patients treated between 1993 to 1994 with wide eyelid retractor (depth 23mm; width 18 mm) were classified as Group A, and the patients treated with narrow retractor (depth 10 mm; width 8 mm) between 1995 to 1996 were classified as Group B, respectively.Results: Of the study subjects, Group A had 209 while Group B had 186 subjects. The age and weight of group A subjects was "mean ± standard deviation" (4.4±4.1 year and 17±12 kg), while that of Group B was (4.7±4.7 year and 20±15 kg). The overall incidence of postoperative JET and mortality was lower in Group B than Group A (2% vs. 10%; p=0.0008; 0% vs. 21%; p<0.05, respectively).Conclusion: A decrease in the incidence of JET and mortality was noticed after the use of narrow retractor.

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Successful management of junctional tachycardia by hypothermia after cardiac operations in infants

Cited by 74 publications

References 14 publications

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

Effects of acute reduction of temperature on ventricular fibrillation activation patterns

Cardiopulmonary Bypass Surgery in Children - Minimizing the Incidence of Postoperative Junctional Ectopic Tachycardia after Surgical Technique Modification

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