Aged ; Diastole ; Female ; Humans ; Tachycardia, Ectopic Atrial ; physiopathology ; therapy

Adolescent ; Atrial Appendage ; Diagnostic Errors ; Female ; Humans ; Tachycardia, Ectopic Atrial ; diagnosis ; Tachycardia, Sinus ; diagnosis

Non sinus focal atrial tachycardia (AT) is an uncommon arrhythmia. Electrocardiograms (ECGs) can be used to diagnose the condition. ECGs can also be used to pinpoint the origin of the focal AT; however, the precise location is ultimately confirmed by electrophysiology. Automaticity, triggered activity, and micro-reentry are possible underlying mechanisms for focal AT. Pharmacological therapy is recommended for symptomatic patients. Radiofrequency catheter ablation is a viable alternative, especially in patients intolerant to drugs, or patients with drug-refractory focal AT. This review describes the epidemiology, clinical features, diagnosis, and mechanisms of focal AT, as well as possible therapeutic approaches for this condition.
Arrhythmias, Cardiac ; Catheter Ablation ; Diagnosis ; Electrocardiography ; Electrophysiology ; Epidemiology ; Humans ; Tachycardia* ; Tachycardia, Ectopic Atrial

BACKGROUND AND OBJECTIVES: The mechanisms of supraventricular tachycardia (SVT) in children are known to have age-dependent distributions. However, the distribution of the mechanisms of tachyarrhythmia, as a whole, is not known in infants and children. The aim of this study was to evaluate the mechanisms of tachyarrhythmia in infants with a structurally normal heart. SUBJECTS AND METHODS: We retrospectively reviewed the mechanisms of tachycardia in 56 children with structurally normal hearts, who had had a tachyarrhythmia in infancy. The mechanisms of tachycardia were confirmed in surface electrocardiogram and by transesophageal, or transvenous, electrophysiological study. RESULTS: The majority of tachycardia during infancy were SVT, in 50 of the 56 (89%). In the infants with SVT, 29 (58%) had atrioventricular reentrant tachycardia using an accessory pathway, With a manifested accessory pathway were in 13 of the 29. Primary atrial tachycardia was found in 19 (38%: a chaotic atrial tachycardia in 10, an atrial flutter in 5 and an atrial ectopic tachycardia in 4). 6 (11%) had a ventricular tachycardia, and of these 5 had a verapamil-sensitive idiopathic left ventricular tachycardia. The most infrequent tachycardia during infancy was an atrioventricular nodal reentrant tachycardia, which occurred in only 2 (4%). 39% of the tachycardia during infancy occurred in the neonatal period. Atrioventricular nodal reentrant and ventricular tachycardia were not found during the neonatal period. CONCLUSION: The most frequent mechanism of tachycardia during infancy was SVT related, with an accessory pathway. Primary atrial and ventricular tachycardia were also found in nearly half the infants, and these were sometimes difficult to manage without understanding their precise mechanism.
Atrial Flutter ; Child ; Electrocardiography ; Heart* ; Humans ; Infant* ; Retrospective Studies ; Tachycardia* ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Ectopic Atrial ; Tachycardia, Supraventricular ; Tachycardia, Ventricular

Atrial Appendage ; physiopathology ; Catheter Ablation ; Child ; Child, Preschool ; Female ; Humans ; Male ; Tachycardia, Ectopic Atrial ; etiology ; surgery ; Tachycardia, Supraventricular ; etiology ; surgery

Tachycardia-induced cardiomyopathy is caused by chronic tachyarrhythmias. It is characterized by ventricular systolic dysfunction and dilatation and by clinical manifestations of heart failure. We experienced three children with tachycardia-induced cardiomyopathy. Two with ectopic atrial tachycardia and one with left ventricular tachycardia were treated successfully by radiofrequency catheter ablation. The clinical and echocardiographic features of cardiomyopathy induced by tachyarrhythmia were reversible after rhythm control. Tachycardia-induced cardiomyopathy should be considered in patient with unexplained systolic dysfunction and any form of tachyarrhythmia as a reversible etiology. Radiofrequency catheter ablation can be a safe and effective treatment in patients with tachyarrhythmia which is complicated by ventricular dysfunction.
Cardiomyopathies* ; Catheter Ablation* ; Child ; Dilatation ; Echocardiography ; Heart Failure ; Humans ; Tachycardia ; Tachycardia, Ectopic Atrial ; Tachycardia, Ventricular ; Ventricular Dysfunction

Adolescent ; Cardiomyopathies ; diagnosis ; etiology ; physiopathology ; Diagnosis, Differential ; Electrocardiography ; Female ; Humans ; Tachycardia, Ectopic Atrial ; complications

Child ; Diagnosis, Differential ; Electrocardiography, Ambulatory ; Heart Atria ; pathology ; Humans ; Tachycardia, Ectopic Atrial ; diagnosis

We report a rare case of atrial tachycardia originating from the non-coronary aortic sinus. After failed radiofrequency (RF) energy applications at right His-bundle region, the complete elimination of atrial tachycardia was achieved with an RF energy application in the non-coronary aortic sinus. With the review of other papers, this report emphasizes the importance of mapping in the non-coronary aortic sinus in focal atrial tachycardia near the atrioventricular node or near the His-bundle.
Catheter Ablation/*methods ; Electrocardiography ; Female ; Humans ; Middle Aged ; Tachycardia, Ectopic Atrial/physiopathology/radiography/*therapy

The conversion of failing Fontan circuit to total cavopulmonary connection(TCPC) is recommended as a therapeutic option in patients with late Fontan complications such as atrial arrhythmia, atrial enlargement, pulmonary venous obstruction, and ventricular dysfunction. Combined TCPC with extracardiac conduit and cryoablation of arrhythmia circuit is preferred for treatment of failing Fontan connection with atrial tachyarrhythmia. We report a case of conversion of atriopulmonary connection to extracardiac conduit Fontan and cryoablation of atrial arrhythmia circuit in a patient with tricuspid atresia, who also had ectopic atrial tachycardia, right atrial thrombi, pulmonary venous obstruction, and ventricular dysfunction. This patient and the parents were Jehovah's Witnesses; therefore, the patient underwent the procedure without blood transfusion.
Arrhythmias, Cardiac* ; Blood Transfusion ; Cryosurgery ; Humans ; Jehovah's Witnesses* ; Parents ; Tachycardia ; Tachycardia, Ectopic Atrial ; Tricuspid Atresia ; Ventricular Dysfunction