Sustained tachyarrhythmia in children younger than 1 year of age: Six year single‐center experience

Şahin, Gülhan Tunca; Öztürk, Erkut; Kaşar, Taner; Güzeltaş, Alper; Ergül, Yakup

doi:10.1111/ped.13445

Cited by 16 publications

(26 citation statements)

References 23 publications

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“…SVT, heart block and ventricular tachycardia were the main arrhythmias reported. Another study from Turkey by Sahin et al [9] included 99 subjects. In this study 36 had common SVT, 27 patients had WPW syndrome, 10 had focal atrial tachycardia (FAT), five had concealed accessory pathway, six had permanent junctional reciprocating tachycardia (PJRT), six had atrial flutter, and one had congenital junctional ectopic tachycardia.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment modalities are various and range from performing simple maneuvers to more complicated pharmacological treatments and pacing [6,7]. Limited data regarding the treatment and management of arrhythmias in neonates (age group 0-29 days) and infants (age group 29 days to 23 months) are coming out from the Middle East with a few studies from Egypt, Turkey, and Iran [8][9][10]. No available data from Lebanon.…”

Section: Introductionmentioning

confidence: 99%

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Arrhythmias in Neonates and Infants at a Tertiary Care Center

Refaat¹,

Abohelwa²,

Ahmed³

et al. 2021

Cureus

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Background Limited data about arrhythmias in neonates and infants are coming out from the Middle East. Objectives To evaluate different types of arrhythmias in neonates and infants at the American University of Beirut Medical Center (AUBMC), a tertiary care center in Lebanon, with the focus on the nature of arrhythmia, treatment modalities and relation to surgery. Methods Data were collected retrospectively from the hospital records. We included all neonates and infants presenting to AUBMC between 2013 and 2017. Collected data included: the type of arrhythmia, the treatment modality used and its success, the need for additional modes of treatment, the relationship to congenital heart diseases, and the cardiac surgeries performed. Results Of 16,346 subjects admitted to AUBMC between 2013 and 2017, 90 subjects developed arrhythmias that required medical intervention. The most frequent types of arrhythmias were supraventricular tachycardia (62.22%), junctional ectopic tachycardia (13.33%), complete heart block (7.78%), atrial flutter (5.56%), multifocal atrial tachycardia (3.33%), Wolf Parkinson White Syndrome (3.33%), non-sustained ventricular tachycardia (2.22%), sinus pause (1.11%), and premature ventricular contractions (1.11%). Bivariate analysis showed a significant difference between arrhythmias not related to cardiac surgery and arrhythmias related to cardiac surgery in terms of the type of arrhythmia developed, the presence of congenital heart defect, prematurity, and electrolyte disturbances (P-value <0.005). However, multivariate logistic regression showed no significant difference between the two groups after adjustment for the significant variables (P-value > 0.05). Conclusion There is a significant difference between arrhythmias not related to cardiac surgery and arrhythmias related to cardiac surgery in neonates and infants at AUBMC. However, the difference disappears after adjusting for different variables.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Arrhythmias in Neonates and Infants at a Tertiary Care Center

Refaat¹,

Abohelwa²,

Ahmed³

et al. 2021

Cureus

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“…A diagnosis of focal atrial tachycardia was based on ECG, 24-hour Holter, or event monitor data consistent with the following electrophysiological criteria: (a) narrow complex tachycardia with visible P waves at an inappropriate rate given the patient's age and activity level; (b) identical abnormal P-wave morphology in the first and all subsequent tachycardia beats; (c) progressive increase in the atrial rate with tachycardia onset (warm-up); (d) variable rate depending on autonomic tone; and (e) first-or second-degree atrioventricular block in the presence of continued tachycardia (10,11) .…”

Section: Methodsmentioning

confidence: 99%

Examining the Correlation Between the GOSE Index and Atrial Arrhythmia Development with Electrocardiographic P-wave Properties in Patients with Ebstein’s Anomaly

Kaşar¹,

Tanıdır²,

Ayyıldız³

et al. 2019

Kosuyolu Heart Journal

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Introduction: Ebstein's anomaly (EA) is a congenital malformation of the tricuspid valve. In the present study, the aim was to examine the relationship between the Great Ormond Street Score (GOSE) index and P-wave characteristics in patients with EA. Patients and Methods: Unoperated patients with EA were evaluated retrospectively. Echocardiographic GOSE indices were calculated for each patient. The P-wave characteristics on the 12-channel electrocardiography (ECG) were also evaluated simultaneously. Results: There were EA 24 cases in the study. The median age was 12 months (range, 1 day-8 years). The median P-wave dispersion was 18 msn (range, 8-36 msn), median P-max duration was 86 msn (range, 58-104 msn), median P-min duration was 62 ms (range, 18-88 msn), and median P amplitude was 2.7 mm (range, 1.2-5 mm). Atrial arrhythmia was detected in eight cases. In the arrhythmia group, the P dispersion and P-max duration were significantly higher than in the non-arrhythmic group (p< 0.05). The median GOSE index was measured as 0.62 (range, 0.2-1.3). The GOSE index grade was detected as Grade 1 in 8 cases, Grade 2 in 12 cases, and Grade 3 in 4 cases. When the patients' GOSE index and P-wave characteristics were evaluated, a positive correlation was found between the P-max (r= 0.5, p= 0.02) and P amplitude (r= 0.780, p= 0.001). There was no significant correlation between the P dispersion and P-min durations (p> 0.05). Conclusion: In EA cases, the GOSE index can be estimated, especially by evaluating the P-wave maximum duration and amplitude. Thus, clinicians may have an idea about the prognosis of cases with EA by evaluating the P-wave changes in ECG and especially the development of supraventricular arrhythmia.

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“…También se pueden dividir en paroxísticas cuando son de inicio y fin súbitos, y no paroxísticas cuando se inician de manera gradual y terminan de la misma manera (2)(3)(4) . La incidencia varía desde 0,1% hasta 0,4% en la población pediátrica (5)(6)(7)(8)(9) , pero algunos estudios latinoamericanos aislados muestran una incidencia mucho mayor, llegando hasta 0,86% (10) ; lamentablemente no tenemos datos nacionales debido, probablemente, a la carencia de centros especializados en el tratamiento invasivo de trastornos del ritmo cardiaco en niños.…”

Section: Introductionunclassified

“…El diagnóstico clínico es complicado en pacientes pequeños, sobre todo los menores de 1 año, ya que los síntomas suelen ser muy inespecíficos, en algunos casos llegándose a confundir con cuadros digestivos como enfermedad por reflujo gastroesofágico, por los vómitos asociados (2,8,12) . El diagnóstico estricto se realiza mediante el trazado electrocardiográfico (ECG), es sencillo si se cuenta con documentación de la taquicardia; sin embargo, dicha documentación muchas veces se muestra evasiva, ya que algunos eventos son de corta duración, por tanto, es hacia ella donde van dirigidas nuestras maniobras diagnósticas y, posteriormente, terapéuticas.…”

Section: Introductionunclassified

Radiofrequency catheter ablation in pediatric population: clinical, electrophysiological and therapeutic characteristics in a Peruvian pediatric hospital

Quicaño

Ccasani

2021

Arch Peru Cardiol Cir Cardiovasc

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Objetivo. Describir las características clínicas, electrofisiológicas y terapéuticas en una población pediátrica con taquicardia supraventricular, sometida a ablación por radiofrecuencia. Materiales y métodos. Estudio observacional, descriptivo, retrospectivo, de niños admitidos para el tratamiento de taquicardia supraventricular en el Instituto Nacional de Salud del Niño durante 2018 a 2021. Resultados. Se recolectaron datos de 62 procedimientos, que correspondían a 59 pacientes (media de edad: 9,91 años, 61% varones), el 23% de procedimientos se realizaron en pacientes menores de 15 kg, y dos fueron en menores de 5 kg. El 63% de pacientes tenían un corazón estructuralmente normal, mientras que el 37% presentaban algún tipo de cardiopatía congénita, la más frecuente fue la anomalía de Ebstein. El grupo de medicamentos más usado fueron los betabloqueadores, principalmente el propranolol. Entre las arritmias tratadas, 21,7% tuvieron síndrome de preexcitación, 33,3% portaban al menos una vía accesoria oculta, 5% correspondían a taquicardia reciprocante permanente de la unión, 5% a taquicardia intranodal, 11,7% taquicardia atrial, 10% flutter atrial, 5% tuvieron otros tipos de taquicardia y en cinco casos no se indujo taquicardia. De la totalidad de procedimientos, 76% correspondían a estudio electrofisiológico y ablación, cuatro pacientes recurrieron. Conclusiones. El sustrato de taquicardia supraventricular más frecuente en pacientes pediátricos fue la presencia de alguna vía accesoria. La ablación con catéter de radiofrecuencia pudo ser aplicado en estos pacientes con una alta tasa de éxito y una baja tasa de complicaciones.

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Sustained tachyarrhythmia in children younger than 1 year of age: Six year single‐center experience

Abstract: Tachyarrhythmias in children <1 year of age are mostly caused by accessory pathways and require multidrug therapy. Catheter ablation is an effective alternative therapy in the case of resistance to medical therapy and/or LV dysfunction.

Cited by 16 publications

References 23 publications

Arrhythmias in Neonates and Infants at a Tertiary Care Center

Arrhythmias in Neonates and Infants at a Tertiary Care Center

Examining the Correlation Between the GOSE Index and Atrial Arrhythmia Development with Electrocardiographic P-wave Properties in Patients with Ebstein’s Anomaly

Radiofrequency catheter ablation in pediatric population: clinical, electrophysiological and therapeutic characteristics in a Peruvian pediatric hospital

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