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Ectopic atrial tachycardia in children
1Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
Journal of the Formosan Medical Association = Taiwan Yi Zhi
|November 4, 2000
Summary
Ectopic atrial tachycardia (EAT) in children often resolves spontaneously or with medication. This study found a 75% spontaneous remission rate, suggesting a step-wise drug approach for effective treatment.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Arrhythmology
Background:
- Ectopic atrial tachycardia (EAT) is a rare but serious arrhythmia in children, potentially leading to left ventricular dysfunction.
- Pediatric EAT may differ from adult EAT due to immature myocardium and distinct conduction tissue characteristics.
Purpose of the Study:
- To investigate the natural history and treatment outcomes of EAT in pediatric patients.
- To compare EAT characteristics in children with and without underlying heart disease.
Main Methods:
- Retrospective analysis of 24 pediatric patients diagnosed with EAT between 1990 and 1999.
- Evaluation of pharmacologic management including digoxin, propranolol, and procainamide, as well as surgical interventions.
Main Results:
- Fifteen patients had healthy hearts; 13 presented with congestive heart failure.
- Pharmacologic treatment controlled EAT in 22 of 24 patients, with a 75% spontaneous remission rate observed.
- Two patients died from uncontrolled arrhythmia, and two from underlying conditions; recurrence occurred in five patients.
Conclusions:
- Antiarrhythmic drugs are effective for treating EAT in children, particularly those without underlying heart disease.
- A step-wise treatment approach involving digoxin, a beta-blocker, and a Class I antiarrhythmic drug is recommended.
- Frequent spontaneous resolution of EAT highlights the importance of monitoring and conservative management strategies.