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Titolo:
Supraventricular tachycardia in infancy and childhood: diagnosis, antiarrhythmic and interventional therapy
Autore:
Paul, T; Bertram, H; Kriebel, T; Windhagen-Mahnert, B; Tebbenjohanns, J; Hausdorf, C;
Indirizzi:
Med Hsch Hannover, Abt Kinderheilkunde 3, Padiatr Kardiol & Padiatr Intensivmed Kinderklin, Hannover, Germany Med Hsch Hannover Hannover Germany sivmed Kinderklin, Hannover, Germany Med Hsch Hannover, Abt Kardiol & Angiol, D-30623 Hannover, Germany Med Hsch Hannover Hannover Germany D-30623 ol, D-30623 Hannover, Germany
Titolo Testata:
ZEITSCHRIFT FUR KARDIOLOGIE
fascicolo: 6, volume: 89, anno: 2000,
pagine: 546 - 558
SICI:
0300-5860(200006)89:6<546:STIIAC>2.0.ZU;2-X
Fonte:
ISI
Lingua:
GER
Soggetto:
RADIOFREQUENCY CATHETER ABLATION; CONGENITAL HEART-DISEASE; INTRAATRIAL REENTRANT TACHYCARDIA; TERM FOLLOW-UP; VENTRICULAR-TACHYCARDIA; ATRIAL-FLUTTER; YOUNG-PATIENTS; PEDIATRIC USE; ACCESSORY PATHWAYS; SMALL CHILDREN;
Keywords:
supraventricular tachycardia; infancy; childhood; pharmacological therapy; endocardial mapping; radiofrequency catheter ablation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
58
Recensione:
Indirizzi per estratti:
Indirizzo: Paul, T Med Hsch Hannover, Abt Kinderheilkunde 3, Padiatr Kardiol & Padiatr Intensivmed Kinderklin, Hannover, Germany Med Hsch Hannover Hannover Germany inderklin, Hannover, Germany
Citazione:
T. Paul et al., "Supraventricular tachycardia in infancy and childhood: diagnosis, antiarrhythmic and interventional therapy", Z KARDIOL, 89(6), 2000, pp. 546-558

Abstract

Supraventricular tachycardias are the most frequent forms of symptomatic tachyarrhythmias in infants, children and adolescents. Clinical symptoms depend on age and underlying cardiac anatomy. Newborn babies and infants with paroxysmal atrioventricular reentrant tachycardias usually present with signs of congestive heart failure due to rapid heart rate. In older children and adolescents, palpitations are the leading symptom. Patients with chronic-permanent tachycardias (i.e., atrial ectopic tachycardia, permanent form of junctional reciprocating tachycardia) often develop a secondary form of dilated cardiomyopathy, the so-called "tachymyopathy'". Adenosine has evolved as the drug of choice in any age group for the termination of atrioventricular reentrant tachycardia of any origin. In addition, it serves as a diagnostic tool in primary atrial tachycardias. Long-term management of atrioventricular reentrant tachycardia in infancy and childhood is age dependent. In newborn babies and infants, pharmacological therapyis advised due to the high spontaneous cessation rate of those tachycardias at die end of the first year of life. In contrast to this, the probability of spontaneous cessation of tachycardia in children >1 year of age is very low. Therefore, radiofrequency catheter ablation of the anatomical substrate of the tachycardia is a rational alternative to long-lasting antiarrhythmic therapy. Results in children with a structurally normal heart are comparable to those achieved in adults. In patients with congenital heart disease and supraventricular tachycardias, catheter ablation during preoperativecardiac catheterization is recommended. Atrial reentrant tachycardias have been identified as one major risk factor for late postoperative morbidity and mortality in young patients. Pharmacological therapy is often not sufficient to control the tachycardia. In addition, underlying sinus node dysfunction may be aggravated in a considerable portion of the patients affected. Catheter ablation based on conventionalendocardial mapping techniques by multipolar electrode catheters with the aim of identifying the critical region of the reentrant circuit is associated with an impaired success rate and a consider able recurrence rate. It may be assumed that, using the modem mapping techniques currently available (electroanatomical mapping and non-contact mapping), results of radiofrequency catheter ablation of atrial reentrant tachycardias after surgical correction of congenital heart disease will be significantly improved within the next few years.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/09/20 alle ore 05:25:29