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Ectopic automatic atrial tachycardia in children: Clinical characteristics, management and follow-up
Open accessAbstract
Ectopic automatic atrial tachycardia, an uncommon type of supraventricular tachycardia in children and adults, has been reported to be resistant to medical therapy, and surgical or cryoblation has been recommended. This report describes 10 infants and children (median age 6 months; range birth to 7.5 years) with automatic atrial tachycardia and their management and follow-up. Digoxin alone was unsuccessful in controlling tachycardia in all 10 patients but decreased the tachycardia rate by 5 to 20% in 8. Intravenous (0.1 mg/kg body weight per dose) and oral propranolol successfully suppressed tachycardia in three of five patients and oral propranolol successfully controlled tachycardia in two of five other patients. Class I antiarrhythmic agents--quinidine (three patients), procainamide (four patients) and phenytoin (three patients)--did not control tachycardia in any patients but made the tachycardia rate worse in three patients. Intravenous (5 mg/kg per dose) and oral amiodarone suppressed tachycardia in three of four patients and oral amiodarone suppressed it in another patient. Thus, intravenous propranolol and amiodarone were effective in acutely suppressing automatic ectopic atrial tachycardia and predicted the response to long-term oral therapy. One patient had persistent tachycardia after surgical ablation of the high right atrial ectopic focus, and another patient had unsuccessful catheter ablation of the high right atrial ectopic focus (25 J). During follow-up (10 to 28 months), ectopic atrial tachycardia resolved completely in four patients and was well controlled in four patients.
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“Beta blockers and calcium-channel blockers may be effective and there is a low risk of side effects.113,114”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [113]
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Metadata
- Authors
- Mehta, A. V., Sanchez, G. R., Sacks, E. J., Casta, A., Dunn, J. M., & Donner, R. M.
- Affiliations
- St. Christopher's Hospital for Children (US)
- Thomas Jefferson University (US)
- Corresponding author
- Mehta, Ashok V.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 1988-02
- Volume
- 11
- Issue
- 2
- Pages
- 379-385
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2031066763
- Cited by
- 132
- References
- 21
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 1 · 2019: 4 · 2018: 2 · 2017: 4 · 2016: 3 · 2015: 8 · 2014: 4 · 2013: 4 · 2012: 3
- FWCI
- 3.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
- Keywords
- supraventricular tachycardia, children, infants, propranolol, amiodarone, digoxin, antiarrhythmic drugs, catheter ablation, surgical ablation
- MeSH terms
- Administration, Oral, Amiodarone, Child, Child, Preschool, Electrocardiography, Electrophysiology, Female, Follow-Up Studies, Humans, Infant, Infusions, Intravenous, Male, Monitoring, Physiologic, Procainamide, Tachycardia, Ectopic Atrial, Tachycardia, Supraventricular
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