Asunto(s)
Arritmias Cardíacas/epidemiología , Arritmias Cardíacas/terapia , Cardiopatías Congénitas/epidemiología , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/prevención & control , Terapia de Resincronización Cardíaca , Ablación por Catéter , Comorbilidad , Desfibriladores Implantables , Técnicas Electrofisiológicas Cardíacas , Accesibilidad a los Servicios de Salud , Cardiopatías Congénitas/diagnóstico , Cardiopatías Congénitas/cirugía , Humanos , Marcapaso ArtificialAsunto(s)
Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/terapia , Cardiopatías Congénitas/diagnóstico , Cardiopatías Congénitas/terapia , Adulto , American Heart Association/organización & administración , Canadá , Electrofisiología Cardíaca/organización & administración , Terapia de Resincronización Cardíaca , Cardiología/organización & administración , Ablación por Catéter , Niño , Desfibriladores Implantables , Técnicas Electrofisiológicas Cardíacas , Europa (Continente) , Humanos , Marcapaso Artificial , Estados UnidosRESUMEN
Supraventricular tachycardia is the most common rhythm disturbance in children. We reviewed the spectrum of this common rhythm disorder from symptom recognition and epidemiology to management, with special attention to advancements in the available treatment options.
Asunto(s)
Taquicardia Supraventricular , Antiarrítmicos/uso terapéutico , Ablación por Catéter , Electrocardiografía , Técnicas Electrofisiológicas Cardíacas , Sistema de Conducción Cardíaco/fisiopatología , Humanos , Educación del Paciente como Asunto , Pronóstico , Deportes , Taquicardia Supraventricular/epidemiología , Taquicardia Supraventricular/fisiopatología , Síndrome de Wolff-Parkinson-White/mortalidadRESUMEN
INTRODUCTION: Nonautomatic focal atrial tachycardia (NAFAT) has been characterized in adults with structurally normal hearts. This article characterizes NAFAT in a population of patients with complex congenital heart disease. METHODS AND RESULTS: Electrophysiologic and electroanatomic mapping data and acute outcomes were reviewed in patients undergoing mapping and ablative procedures for atrial tachycardia at Children's Hospital, Boston, between January 1999 and December 2003. Twenty-two NAFAT foci were identified in 17 patients out of 216 patients studied. Fourteen of these 17 patients had congenital heart disease. The average age of the patients with a NAFAT mechanism was 27 years and there was no gender predilection. The presumptive diagnosis based on clinical grounds and surface ECG assessment in 11 of 17 patients with NAFAT was atrial flutter. None of the 17 patients were suspected of having a NAFAT mechanism by noninvasive assessment. Four of the 10 patients had both NAFAT and macroreentrant atrial tachycardias. NAFAT cycle lengths varied widely (200-680 ms) between patients. Sixteen of the 22 NAFAT foci were mapped to the anatomic right atrium (RA). Acute ablative success was achieved in 17 out of 22 foci (77%). CONCLUSION: NAFAT is relatively uncommon in a pediatric tertiary care setting, and in that setting occurs most often in adults with congenital heart disease. NAFAT is indistinguishable from other forms of atrial tachycardia by noninvasive means and can mimic other forms of atrial tachycardia on electrocardiogram. The foci were predominantly found in the RA and were, in most cases, acutely amenable to catheter ablation therapy.
Asunto(s)
Ablación por Catéter/métodos , Cardiopatías Congénitas/complicaciones , Taquicardia Atrial Ectópica/cirugía , Adolescente , Adulto , Niño , Preescolar , Técnicas Electrofisiológicas Cardíacas , Femenino , Estudios de Seguimiento , Cardiopatías Congénitas/fisiopatología , Frecuencia Cardíaca/fisiología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Taquicardia Atrial Ectópica/complicaciones , Taquicardia Atrial Ectópica/fisiopatología , Resultado del TratamientoRESUMEN
A 31-year-old woman with tricuspid atresia and a palliative Waterston shunt presented with intractable poorly tolerated supraventricular tachycardia. Electrophysiologic evaluation was consistent with AV nodal reentrant tachycardia. The fast pathway region was mapped electroanatomically during tachycardia and with constant rate ventricular pacing. Successful radiofrequency ablation was achieved by placement of lesions in an area adjacent and inferior to the His-bundle electrogram on the left side of the septum.