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Titolo:
Ectopic atrial tachycardia in children
Autore:
Wang, JN; Wu, JM; Tsai, YC; Lin, CS;
Indirizzi:
Natl Cheng Kung Univ Hosp, Coll Med, Dept Pediat, Tainan 70101, Taiwan Natl Cheng Kung Univ Hosp Tainan Taiwan 70101 diat, Tainan 70101, Taiwan Tainan Municipal Hosp, Dept Pediat, Tainan, Taiwan Tainan Municipal Hosp Tainan Taiwan l Hosp, Dept Pediat, Tainan, Taiwan
Titolo Testata:
JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION
fascicolo: 10, volume: 99, anno: 2000,
pagine: 766 - 770
SICI:
0929-6646(200010)99:10<766:EATIC>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
INDUCED CARDIOMYOPATHY; FOLLOW-UP; MANAGEMENT; INFANTS;
Keywords:
ectopic atrial tachycardia; child;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
14
Recensione:
Indirizzi per estratti:
Indirizzo: Wu, JM Natl Cheng Kung Univ Hosp, Coll Med, Dept Pediat, 138 Sheng Li Rd, Tainan 70101, Taiwan Natl Cheng Kung Univ Hosp 138 Sheng Li Rd Tainan Taiwan 70101 iwan
Citazione:
J.N. Wang et al., "Ectopic atrial tachycardia in children", J FORMOS ME, 99(10), 2000, pp. 766-770

Abstract

Background and purpose: Ectopic atrial tachycardia (EAT) is an unusual andpotentially risky arrhythmia that can result ill left ventricular dysfunction if not properly managed. In adults, EAT is mainly caused by diseased atrial myocardium and responds poorly to antiarrhythmic drugs. The characteristics of EXT in children might be different from those in adults because oftheir immature myocardium and the different electrophysiologic characteristics of their conduction tissue. We examined the natural history and treatment of EAT in children. Methods and results: From June 1990 through June 1999, 24 children (8 girls and 16 boys: median age 4 mo [1 d-10 yr]) were admitted to our hospital with a diagnosis of EAT. Fifteen had healthy hearts, six had congenital heart disease, one hall myocarditis, one had bronchopulmonary dysplasia with 1 severe pulmonary hypertension, and one had hypertrophic cardiomyopathy. Thirteen patients presented with congestive heart failure. Only four patients had symptoms of prodromal airway infection. The maximum atrial rare was 244+/- 66 beats per minute. Atrioventricular block was documented at least once during tachycardia in 10 patients. Warm-up or cool-down phenomenon was seen at the initiation or termination of tachycardia in thirteen patients. Primary pharmacologic treatment was attempted in all patients. EAT was initially controlled in all patients using digoxin plus propranolol (18 patients), propranolol only (4), or digoxin plus procainamide (2). EAT was controlled using medication in 22 patients. Fifteen patients had sinus rhythm but did not receive medication fur 39 +/- 25 months. Two patients died of uncontrolled arrhythmia, and two of underlying disease. Recurrence was seen within 3 months after initial therapy in five patients. Surgery was performed tocorrect the underlying heart disease in three patients with frequently recurring EAT, all of whom remained tachycardia-free after surgery, without pharmacologic treatment. The spontaneous remission rate was 75% (18/24). Conclusion: EAT in children without under lying heart disease can be effectively treated using antiarrhythmic drugs. Spontaneous resolution of EAT after medication in children was frequent (75%) in this series. The results of this study suggest that a step-wise approach using digoxin, a beta-blocker, and a class I antiarrhythmic drug may be the most effective treatment for EAT.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 03:25:31