Pediatric Nonpost-Operative Junctional Ectopic Tachycardia : Medical Management and Interventional Therapies

Kathryn K COLLINS; Ian H LAW; George F VAN HARE; Narayanswami SREERAM; Michael S SCHAFFER; Anne FOURNIER; Shubhayan SANATANI; Christopher S SNYDER; Richard T SMITH; Luis ARABIA; Robert HAMILTON; Terrence CHUN; Leonardo LIBERMAN; Naomi J KERTESZ; Bahram KAKAVAND; Thomas PAUL; Ronn E TANEL; Yaniv BAR-COHEN; Anne M DUBIN; Susan P ETHERIDGE; Charles I BERUL; Jennifer N AVARI; Volkan TUZCU

doi:10.1016/j.jacc.2008.11.019

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Pediatric Nonpost-Operative Junctional Ectopic Tachycardia : Medical Management and Interventional Therapies

Journal article

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Pediatric Nonpost-Operative Junctional Ectopic Tachycardia : Medical Management and Interventional Therapies

Kathryn K COLLINS, Ian H LAW, George F VAN HARE, Narayanswami SREERAM, Michael S SCHAFFER, Anne FOURNIER, Shubhayan SANATANI, Christopher S SNYDER, Richard T SMITH, Luis ARABIA, …

Journal of the American College of Cardiology, Vol.53(8), pp.690-697

2009

DOI: 10.1016/j.jacc.2008.11.019

PMID: 19232902

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Abstract

Objectives To determine the outcomes of medical management, pacing, and catheter ablation for the treatment of nonpost-operative junctional ectopic tachycardia (JET) in a pediatric population. Background Nonpost-operative JET is a rare tachyarrhythmia that is associated with a high rate of morbidity and mortality. Most reports of clinical outcomes were published before the routine use of amiodarone or ablation therapies. Methods This is an international, multicenter retrospective outcome study of pediatric patients treated for nonpost-operative JET. Results A total of 94 patients with JET and 5 patients with accelerated junctional rhythm (age 0.8 year, range fetus to 16 years) from 22 institutions were identified. JET patients presenting at age ≤6 months were more likely to have incessant JET and to have faster JET rates. Antiarrhythmic medications were utilized in a majority of JET patients (89%), and of those, amiodarone was the most commonly reported effective agent (60%). Radiofrequency ablation was conducted in 17 patients and cryoablation in 27, with comparable success rates (82% radiofrequency vs. 85% cryoablation, p = 1.0). Atrioventricular junction ablation was required in 3% and pacemaker implantation in 14%. There were 4 (4%) deaths, all in patients presenting at age ≤6 months. Conclusions Patients with nonpost-operative JET have a wide range of clinical presentations, with younger patients demonstrating higher morbidity and mortality. With current medical, ablative, and device therapies, the majority of patients have a good clinical outcome.

Cardiology. Vascular system

Biological and medical sciences

Medical sciences

Details

Title: Subtitle: Pediatric Nonpost-Operative Junctional Ectopic Tachycardia : Medical Management and Interventional Therapies
Creators: Kathryn K COLLINS - Department of Pediatrics, Division of Cardiology, The Children's Hospital, Denver, Colorado, United States
Ian H LAW - Department of Pediatrics, Division of Cardiology, University of Iowa Children's Hospital, Iowa City, Iowa, United States
George F VAN HARE - Department of Pediatrics, Division of Cardiology, University of California, San Francisco, California, United States
Narayanswami SREERAM - Department of Pediatrics, Division of Cardiology, University Hospital of Cologne, Koln, Germany
Michael S SCHAFFER - Department of Pediatrics, Division of Cardiology, The Children's Hospital, Denver, Colorado, United States
Anne FOURNIER - Department of Pediatrics, Division of Cardiology, Hospital Sainte-Justine, Montreal, Quebec, Canada
Shubhayan SANATANI - Department of Pediatrics, Division of Cardiology, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
Christopher S SNYDER - Department of Pediatrics, Division of Cardiology, Ochsner Children's Hospital, New Orleans, Louisiana, United States
Richard T SMITH - Department of Pediatrics, Division of Cardiology, Sanger Clinic, Charlotte, North Carolina, United States
Luis ARABIA - Department of Pediatrics, Division of Cardiology, Sanatorio del Salvador, Argüello, Cordoba, Argentina
Robert HAMILTON - Hospital for Sick Children
Terrence CHUN - Department of Pediatrics, Division of Cardiology, Children's Heat Center, Seattle, Washington, United States
Leonardo LIBERMAN - Department of Pediatrics, Division of Cardiology, Children's Hospital of New York-Presbyterian, New York, New York, United States
Naomi J KERTESZ - Department of Pediatrics, Division of Cardiology, Texas Children's Hospital, Houston, Texas, United States
Bahram KAKAVAND - Department of Pediatrics, Division of Cardiology, University of Kentucky, Lexington, Kentucky, United States
Thomas PAUL - Department of Pediatrics, Division of Cardiology, Georg-August-University, Gottingen, Germany
Ronn E TANEL - Department of Pediatrics, Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
Yaniv BAR-COHEN - Department of Pediatrics, Division of Cardiology, Children's Hospital, Los Angeles, California, United States
Anne M DUBIN - Department of Pediatrics, Division of Cardiology, Stanford University, Palo Alto, California, United States
Susan P ETHERIDGE - Department of Pediatrics, Division of Cardiology, Primary Children's Hospital, Salt Lake City, Utah, United States
Charles I BERUL - Department of Pediatrics, Division of Cardiology, Children's Hospital, Boston, Massachusetts, United States
Jennifer N AVARI - Department of Pediatrics, Division of Cardiology, Washington University School of Medicine/St. Louis Children's Hospital, St. Louis, Missouri, United States
Volkan TUZCU - Department of Pediatrics, Division of Cardiology, Arkansas Children's Hospital, Little Rock, Arkansas, United States
Resource Type: Journal article
Publication Details: Journal of the American College of Cardiology, Vol.53(8), pp.690-697
DOI: 10.1016/j.jacc.2008.11.019
PMID: 19232902
NLM abbreviation: J Am Coll Cardiol
ISSN: 0735-1097
eISSN: 1558-3597
Publisher: Elsevier
Grant note: DOI: 10.13039/100004374, name: Medtronic
Language: English
Date published: 2009
Academic Unit: Cardiology; Stead Family Department of Pediatrics
Record Identifier: 9984093334402771

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