[Surgical treatment of children with ectopic atrial tachycardia]

Up-to-date electrophysiologic investigations of the heart, carried out in 212 children with arrhythmias, demonstrated a focus of ectopic atrial tachycardia in 21 (9.9%); 17 of those underwent long-term treatment (up to 10 years) with antiarrhythmic drugs. Kordaron produced a positive effect (discontinuation of the attacks) in 1 case only. Combined use of several antiarrhythmic drugs controlled the frequency of tachycardia in 4 patients. Signs of dilatation cardiomyopathy were in evidence in 60% of children with permanent ectopic tachycardia. Seven of 12 patients who failed to respond to medication were eventually subjected to radical surgery. All but one were discharged from hospital without additional medication and with normal heart rhythm. One child developed groups of extrasystoles generated by the lower right-atrial portion during the 2nd week after surgery. They diminished and eventually disappeared after a supportive digoxin treatment. Surgery is therefore regarded as an effective and radical treatment for ectopic atrial tachycardia in children.