HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Management of cardiomyopathy resulting from incessant supraventricular tachycardia in infants and children.

AbstractBACKGROUND:
Radiofrequency ablation is considered to be the treatment of choice in patients with ventricular dysfunction related to incessant supraventricular tachycardia. However, reservations regarding its use in infants and children prompted us to try alternative strategies for this group.
METHODS AND RESULTS:
Eight children (age range: 1 day to 10 years) were diagnosed to have tachycardia-related ventricular dysfunction in the past 6 years. They presented with symptoms of palpitation, dyspnea and/or generalized swelling over the body of 3 months to 2 years'duration. The cardiothoracic ratio at presentation was 64% (52%-70%) and ejection fraction was 22.2% (15%-45%). In 7 patients tachycardia was diagnosed to be ectopic atrial and in 1 it was permanent junctional reciprocating tachycardia. Six of these children were managed with intravenous/oral amiodarone in combination with digoxin (3) and/or propranolol (2). In one child addition of amiodarone to digoxin and propranolol led to polymorphic ventricular tachycardia, and amiodarone was withdrawn. Only one child underwent radiofrequency ablation as the first choice because regular follow-up was not possible due to logistic reasons. Sinus rhythm with normalization of ventricular function was achieved in 6 of the 7 children treated medically. One child continued to have frequent episodes of tachycardia and underwent successful radiofrequency ablation of a high right atrial ectopic focus. Two out of the 6 patients on amiodarone could be managed with only digoxin and propranolol after their ventricular function had returned to normal. A third patient relapsed on stopping amiodarone and underwent successful radiofrequency ablation of a left atrial ectopic tachycardia.
CONCLUSIONS:
Short-term amiodarone in combination with digoxin/propranolol is a safe and effective treatment strategy for infants/children with tachycardiomyopathy. Control of tachycardia is achieved in the majority, leading to recovery of ventricular function. This approach may avoid unnecessary ablations in children or at least postpone it till the procedure would be safer.
AuthorsR Juneja, S Shah, N Naik, S S Kothari, A Saxena, K K Talwar
JournalIndian heart journal (Indian Heart J) 2002 Mar-Apr Vol. 54 Issue 2 Pg. 176-80 ISSN: 0019-4832 [Print] India
PMID12086381 (Publication Type: Journal Article)
Chemical References
  • Anti-Arrhythmia Agents
  • Digoxin
  • Propranolol
  • Amiodarone
Topics
  • Amiodarone (therapeutic use)
  • Anti-Arrhythmia Agents (therapeutic use)
  • Cardiomyopathies (drug therapy, etiology)
  • Catheter Ablation
  • Child
  • Child, Preschool
  • Digoxin (therapeutic use)
  • Drug Therapy, Combination
  • Echocardiography
  • Electrocardiography
  • Humans
  • Infant
  • Infant, Newborn
  • Propranolol (therapeutic use)
  • Tachycardia, Supraventricular (complications)
  • Ventricular Dysfunction, Left (drug therapy, etiology)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: