Permanent junctional reciprocating tachycardia in infants and children: Effectiveness of medical and non-medical treatment

F. Drago, M. S. Silvetti, A. Mazza, S. Anaclerio, A. Di Pino, G. Grutter, M. Bevilacqua

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Abstract

Background. The aim of this study was to identify, in children affected by permanent junctional reciprocating tachycardia (PJRT), the effective treatment. Methods. Seventeen children (9 males, 8 females, mean age 59 ± 62 months, median 24) affected by PJRT were referred to our Institute between the years 1987 and 2000. Results. Pharmacological therapy was successfully used in 14 patients: flecainide and propranolol in 5 of them, amiodarone alone in 5 and associated with propranolol in 2, propafenone alone in 1 and in association with sotalol in 1. These drugs were given for a mean period of 54.5 ± 49.8 months with resolution of the cardiomyopathy in 7/7 patients. Treatment had been continued for 3-6 months and there were no side effects. Nine patients were treated with radiofrequency transcatheter ablation, after 78 ± 53.5 months of medical treatment, at a mean age of 150 ± 16 months. The shortest endocardial ventriculo-atrial (VA) interval during tachycardia was recorded in all cases at the coronary sinus ostium (mean value of local VA-surface RP' interval -38 ms, range -24/-55 ms). Successful ablation of the anomalous pathway was obtained at this site in all patients (mean watts delivered 26 ± 3 W, mean T° 64 ± 5°C). During the follow-up period (mean 21 ± 17 months) 2 patients with recurrences of PJRT underwent a second successful procedure. Conclusions. PJRT in pediatric patients can be successfully treated with antiarrhythmic drugs, this may allow delay of the highly effective radiofrequency ablation treatment until the children have reached an adequate growth.

Original languageEnglish
Pages (from-to)456-461
Number of pages6
JournalItalian Heart Journal
Volume2
Issue number6
Publication statusPublished - 2001

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Keywords

  • Children
  • Radiofrequency transcatheter ablation
  • Supraventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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