Clinical course and treatment of ectopic atrial tachycardia in 144 children

OBJECTIVE: Ectopic atrial tachycardia (EAT) is a common type of supraventricular tachycardia in pediatric population, and it can be resistant to antiarrhythmic drugs and lead to tachycardia induced cardiomyopathy (TIC) if not properly managed. This study assessed the clinical course and response to...

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Veröffentlicht in:Zhonghua er ke za zhi = Chinese journal of pediatrics. - 1960. - 53(2015), 3 vom: 01. März, Seite 214-9
1. Verfasser: Ge, Haiyan (VerfasserIn)
Weitere Verfasser: Li, Xiaomei, Zhang, Yan, Liu, Haiju, Jiang, He
Format: Aufsatz
Sprache:Chinese
Veröffentlicht: 2015
Zugriff auf das übergeordnete Werk:Zhonghua er ke za zhi = Chinese journal of pediatrics
Schlagworte:Journal Article Anti-Arrhythmia Agents Sotalol A6D97U294I Amiodarone N3RQ532IUT
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245 1 0 |a Clinical course and treatment of ectopic atrial tachycardia in 144 children 
264 1 |c 2015 
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520 |a OBJECTIVE: Ectopic atrial tachycardia (EAT) is a common type of supraventricular tachycardia in pediatric population, and it can be resistant to antiarrhythmic drugs and lead to tachycardia induced cardiomyopathy (TIC) if not properly managed. This study assessed the clinical course and response to treatment of EAT in children 
520 |a METHOD: A retrospective review included 144 children at the First Hospital of Tsinghua University diagnosed with EAT from January 2009 to April 2014. The clinical detailed history, 12 lead ECG, 24-h Holter recording, echocardiography, response to therapy and follow-up were analyzed 
520 |a RESULT: The onset of EAT occurred at any age with a distribution with positive skewness, 57 children ≤1 years, 22 children > 1 - 3 years, 25 children > 3 - 6 years and 40 children ≥ 6 years of age. The percentages of the three tachycardia types were 36. 1% (n = 52) for incessant EAT, 52. 8% (n = 76) for paroxysmal EAT and 11. 1% (n = 16) for sporadic EAT, respectively. There were 115 patients received drug therapy in our hospital and in 72 cases the EAT was completely controlled. Antiarrhythmic therapy had been discontinued in 35 children with complete control. Normal sinus rhythm was observed by telemetry or Holter within 4 to 90 days and the mean duration of medical therapy was 310 days (range 15 to 608 days) in these children. The combination of sotalol and propafenone showed better effectiveness for control of children with EAT (54%, 41/76), compared with single sotalol (36%, 24/66) and the combination of amiodarone and metoprolol (30%, 7/23) (χ2 = 6. 296, P = 0. 043). Tachycardia type was able to predict the response to antiarrhythmic drugs for children with EAT, sporadic tachycardia had best control rate on pharmacological therapy compared with paroxysmal tachycardia and incessant tachycardia (94% (15/16) vs. 67% (42/63) vs. 42% (15/36), χ2 = 17. 925, P = 0. 000) . Acute success of radiofrequency ablation (RFA) in children who showed poor response to antiarrhythmic drugs was achieved in 45 of 49 (92%), ultimate success was achieved in 33 of 49 (67%). The incidence of TIC secondary to EAT was 18. 1% (n =26), and left ventricular ejection-fraction (LVEF) returned to normal in 23 children after successful control of EAT ((61 ± 4) % vs. (43 ± 5) %, t = - 10. 036, P = 0. 000). Side effects including abnormal thyroid function (in 3) and abnormal liver function (in 1) occurred in 4 (17%) of 23 children who received amiodarone and disappeared when amiodarone was discontinued 
520 |a CONCLUSION: EAT in children predominantly occurred in young infants and children. Incessant EAT comprised a great percentage. The combination of sotalol and propafenone provided the best results for control of children with EAT. RFA should be considered as a preferred treatment for older children who displayed poor response to medical therapy 
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650 7 |a N3RQ532IUT  |2 NLM 
700 1 |a Li, Xiaomei  |e verfasserin  |4 aut 
700 1 |a Zhang, Yan  |e verfasserin  |4 aut 
700 1 |a Liu, Haiju  |e verfasserin  |4 aut 
700 1 |a Jiang, He  |e verfasserin  |4 aut 
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