Skip to main content
Erschienen in: Pediatric Cardiology 4/2006

01.08.2006

Atrioventricular Nodal Reentrant Tachycardia in Children

verfasst von: Fabrizio Drago, Giorgia Grutter, Massimo S. Silvetti, Antonella De Santis, Vincenzo Di Ciommo

Erschienen in: Pediatric Cardiology | Ausgabe 4/2006

Einloggen, um Zugang zu erhalten

Abstract

The purpose of this study was to identify the clinical and electrophysiological characteristics of children with atrioventricular reentry tachycardia (AVNRT) and to define the prognosis and the treatment strategy. Sixty-two children (28 males and 34 females mean age, 10.2 ± 3.2 years) with AVNRT (“slow–fast” type) were included in the study. Patients were divided into two groups: 47 patients with severe symptoms (group A) and 15 with mild symptoms (group B). The severity of the symptoms was not related to the electrophysiological parameters. Females were more symptomatic than males. Patients in group B did not receive any treatment (except 1 because of parents’ choice) nor did they develop symptoms, and 5 patients had resolution of palpitations. Forty-one of 46 patients in group A were successfully treated with medical therapy as initial treatment. Thirty-one patients in group A underwent slow pathway ablation. There were late recurrences of AVNRT in 6 patients. Typical AVNRT in young patients does not appear to be life threatening. Patients with mild or no symptoms do well without therapy. Medical therapy and slow pathway ablation appear to be effective in the more symptomatic patients. Age and electrophysiological variables are not related to the symptoms or response to treatment. Females with AVNRT are more symptomatic and more likely to present with syncope.
Literatur
1.
Zurück zum Zitat Akhtar M, Jazayeri MR, Sra J, et al. (1993) Atrioventricular nodal reentry, clinical, electrophysiological and therapeutic considerations. Circulation 88:282–295PubMed Akhtar M, Jazayeri MR, Sra J, et al. (1993) Atrioventricular nodal reentry, clinical, electrophysiological and therapeutic considerations. Circulation 88:282–295PubMed
2.
Zurück zum Zitat Baker JH, Plumb VJ, Epstein AE, et al. (1994) Predictors of recurrent atrioventricular nodal reentry after selective slow pathway ablation. Am J Cardiol 128:219–226 Baker JH, Plumb VJ, Epstein AE, et al. (1994) Predictors of recurrent atrioventricular nodal reentry after selective slow pathway ablation. Am J Cardiol 128:219–226
3.
Zurück zum Zitat Bertram H, Windhagen-Mahnert B, Bokekamp R, et al. (2001) Abbreviated combined anatomical/electrophysiological approach for catheter ablation of atrioventricular nodal reentry tachycardia in children. Cardiol Young 11:182–187PubMed Bertram H, Windhagen-Mahnert B, Bokekamp R, et al. (2001) Abbreviated combined anatomical/electrophysiological approach for catheter ablation of atrioventricular nodal reentry tachycardia in children. Cardiol Young 11:182–187PubMed
4.
Zurück zum Zitat Blaufox AD, Rhodes JF, Fishberger SP (2000) Age related changes in dual AV nodal physiology. PACE 23:477–480PubMed Blaufox AD, Rhodes JF, Fishberger SP (2000) Age related changes in dual AV nodal physiology. PACE 23:477–480PubMed
5.
Zurück zum Zitat Cohen MI, Wicand TS, Rhodes LA, Vetter VL (1997) Electrophysiologic properties of the atrioventricular node in pediatric patients. J Am Coll Cardiol 29:403–407PubMedCrossRef Cohen MI, Wicand TS, Rhodes LA, Vetter VL (1997) Electrophysiologic properties of the atrioventricular node in pediatric patients. J Am Coll Cardiol 29:403–407PubMedCrossRef
6.
Zurück zum Zitat Dhala A, Bremner S, Deshpande S, et al. (1994) Efficacy and safety of atrioventricular nodal modification for atrioventricular nodal reentrant tachycardia in the pediatric population. Am Heart 128:903–907CrossRef Dhala A, Bremner S, Deshpande S, et al. (1994) Efficacy and safety of atrioventricular nodal modification for atrioventricular nodal reentrant tachycardia in the pediatric population. Am Heart 128:903–907CrossRef
7.
Zurück zum Zitat DuBrow IW, Fisher EA, Amix Y, et al. (1975) Comparison of cardiac refractory periods in children and adults. Circulation 51:482–491 DuBrow IW, Fisher EA, Amix Y, et al. (1975) Comparison of cardiac refractory periods in children and adults. Circulation 51:482–491
8.
Zurück zum Zitat Friedman RA, Walsh EP, Silka MJ, et al. (2002) NASPE expert consensus conference: radiofrequency catheter ablation in children with and without congenital heart disease. Report of the writing committee. PACE 25:1000–1017PubMed Friedman RA, Walsh EP, Silka MJ, et al. (2002) NASPE expert consensus conference: radiofrequency catheter ablation in children with and without congenital heart disease. Report of the writing committee. PACE 25:1000–1017PubMed
9.
Zurück zum Zitat Fujii E, Kasai A, Omichi C, et al. (2000) Electrophysiological determinants of persistent dual atrioventricular nodal pathway physiology, after slow pathway ablation in atrioventricular nodal reentrant tachycardia. PACE 23:1916–1920PubMed Fujii E, Kasai A, Omichi C, et al. (2000) Electrophysiological determinants of persistent dual atrioventricular nodal pathway physiology, after slow pathway ablation in atrioventricular nodal reentrant tachycardia. PACE 23:1916–1920PubMed
10.
Zurück zum Zitat Gross G, Epstein MR, Walsh EP, Saul P (1998) Characteristics, management and midterm outcome in infants with atrioventricular nodal reentry tachycardia. Am J Cardiol 82:956–960CrossRef Gross G, Epstein MR, Walsh EP, Saul P (1998) Characteristics, management and midterm outcome in infants with atrioventricular nodal reentry tachycardia. Am J Cardiol 82:956–960CrossRef
11.
Zurück zum Zitat Haissaguerre W, Warin JF, Lemetayer PH, et al. (1986) Closed-chest ablation of retrograde conduction in patients with atrioventricular nodal reentrant tachycardia. Prog Clin Pacing 7:570–578 Haissaguerre W, Warin JF, Lemetayer PH, et al. (1986) Closed-chest ablation of retrograde conduction in patients with atrioventricular nodal reentrant tachycardia. Prog Clin Pacing 7:570–578
12.
Zurück zum Zitat Jackman WM, Wong X, Friday KJ, et al. (1991) Catheter ablation of accessory atrioventricular pathways by radiofrequency current. N Engl J Med 324:1605–1611PubMedCrossRef Jackman WM, Wong X, Friday KJ, et al. (1991) Catheter ablation of accessory atrioventricular pathways by radiofrequency current. N Engl J Med 324:1605–1611PubMedCrossRef
13.
Zurück zum Zitat James FW, Kaplan S, Glueek CJ, et al. (1980) Response of normal children and young adults to controlled bicycle exercise. Circulation 61:902–912PubMed James FW, Kaplan S, Glueek CJ, et al. (1980) Response of normal children and young adults to controlled bicycle exercise. Circulation 61:902–912PubMed
14.
Zurück zum Zitat Lee PC, Chen SA, Chiang CE, et al. (2003) Clinical and electrophysiological characteristics in children with atrioventricular nodal reentrant tachycardia. Pediatr Cardiol 24:6–9PubMedCrossRef Lee PC, Chen SA, Chiang CE, et al. (2003) Clinical and electrophysiological characteristics in children with atrioventricular nodal reentrant tachycardia. Pediatr Cardiol 24:6–9PubMedCrossRef
15.
Zurück zum Zitat Lein MH, Young ML, Wu JM, et al. (1997) Development changes of atrioventricular nodal recovery properties. Am J Cardiol 80:1178–1182CrossRef Lein MH, Young ML, Wu JM, et al. (1997) Development changes of atrioventricular nodal recovery properties. Am J Cardiol 80:1178–1182CrossRef
16.
Zurück zum Zitat Ludormisky A, Garson A Supraventricular tachycardia. In: Gillette PC, Garson A (eds) Pediatric Arrhythymias: Electrophysiology and Pacing. Saunders. Philadelphia Ludormisky A, Garson A Supraventricular tachycardia. In: Gillette PC, Garson A (eds) Pediatric Arrhythymias: Electrophysiology and Pacing. Saunders. Philadelphia
17.
Zurück zum Zitat Otto H, Teixeira P, Seshadri B, Case CL, Gillette P (1994) Radiofrequnecy catheter ablation of atrioventricular nodal reentrant tachycardia in children. PACE 17: 1621–1626 Otto H, Teixeira P, Seshadri B, Case CL, Gillette P (1994) Radiofrequnecy catheter ablation of atrioventricular nodal reentrant tachycardia in children. PACE 17: 1621–1626
18.
Zurück zum Zitat Poret P, Leclercq C, Gras D, et al. (2000) Junctional rhythm during slow pathway radiofrequency ablation in patients with atrioventricular nodal reentrant tachycardia: beat-to-beat analysis and its prognostic value in relation to electrophysiologic and anatomic parameters. J Cardiovasc Electrophysiol 11:405–412PubMed Poret P, Leclercq C, Gras D, et al. (2000) Junctional rhythm during slow pathway radiofrequency ablation in patients with atrioventricular nodal reentrant tachycardia: beat-to-beat analysis and its prognostic value in relation to electrophysiologic and anatomic parameters. J Cardiovasc Electrophysiol 11:405–412PubMed
19.
Zurück zum Zitat Rhodes LA, Wieand TS, Vetter VL (1999) Low temperature and low energy radiofrequency modification of atrioventricular nodal slow pathways in pediatric patients. PACE 22:1071–1078PubMed Rhodes LA, Wieand TS, Vetter VL (1999) Low temperature and low energy radiofrequency modification of atrioventricular nodal slow pathways in pediatric patients. PACE 22:1071–1078PubMed
20.
Zurück zum Zitat Schaffer SM, Gillette PC (1991) Ventriculoatrial intervals during narrow complex re-entrant tachycardia in children. Am Heart J 121:1699–1702PubMedCrossRef Schaffer SM, Gillette PC (1991) Ventriculoatrial intervals during narrow complex re-entrant tachycardia in children. Am Heart J 121:1699–1702PubMedCrossRef
21.
Zurück zum Zitat Silka MJ, Kron J, Blair D, Halperin BD, Mc Anulty JH (1994) Mechanism of AV node reentrant tachycardia in young patients with and without dual AV node physiology. PACE 17:2129–2133PubMed Silka MJ, Kron J, Blair D, Halperin BD, Mc Anulty JH (1994) Mechanism of AV node reentrant tachycardia in young patients with and without dual AV node physiology. PACE 17:2129–2133PubMed
22.
Zurück zum Zitat Tsuchiya T, Okuma K, Tabuchi T, et al. (1999) Atrial ectopy originating from the posteroinferior atrium during radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia. PACE 22:727–737PubMed Tsuchiya T, Okuma K, Tabuchi T, et al. (1999) Atrial ectopy originating from the posteroinferior atrium during radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia. PACE 22:727–737PubMed
23.
Zurück zum Zitat Wagshad AB, Crystal E, Amas K (2000) Patterns of accelerated injunctional rhythm during slow pathway catheter ablation for atrioventricular nodal reentrant tachycardia: temperature dependence, prognostic value and insights into the nature of the slow pathway. J Cardiovasc Electrophysiol 11:244–254 Wagshad AB, Crystal E, Amas K (2000) Patterns of accelerated injunctional rhythm during slow pathway catheter ablation for atrioventricular nodal reentrant tachycardia: temperature dependence, prognostic value and insights into the nature of the slow pathway. J Cardiovasc Electrophysiol 11:244–254
24.
Zurück zum Zitat Waki K, Jung-Sun K, Becker AE (2000) Morphology of the human arioventricular node is age dependent: a feature of potential clinical significance. J Cardiovasc Electrophysiol 11:1144–1151 Waki K, Jung-Sun K, Becker AE (2000) Morphology of the human arioventricular node is age dependent: a feature of potential clinical significance. J Cardiovasc Electrophysiol 11:1144–1151
Metadaten
Titel
Atrioventricular Nodal Reentrant Tachycardia in Children
verfasst von
Fabrizio Drago
Giorgia Grutter
Massimo S. Silvetti
Antonella De Santis
Vincenzo Di Ciommo
Publikationsdatum
01.08.2006
Erschienen in
Pediatric Cardiology / Ausgabe 4/2006
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-006-1279-2

Weitere Artikel der Ausgabe 4/2006

Pediatric Cardiology 4/2006 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.