CLINICAL COURSE AND ELECTROPHYSIOLOGICAL CHARACTERISTICS OF PERMANENT JUNCTIONAL RECIPROCATING TACHYCARDIA IN CHILDREN: TEN YEARS EXPERIENCE


Ergul Y., Sülü A., Caran B., Kafali H. C., Güzeltas A., Akdeniz C., ...More

AEPC 2022 - 55th Annual Meeting of the Association for European Paediatric and Congenital Cardiology , Geneve, Switzerland, 25 - 28 May 2022, pp.491

  • Publication Type: Conference Paper / Full Text
  • City: Geneve
  • Country: Switzerland
  • Page Numbers: pp.491
  • Eskisehir Osmangazi University Affiliated: Yes

Abstract

BACKGROUND AND AIM: In this study, we aimed to evaluate the clinical features,

electrophysiological study, and ablation results of permanent junctional reciprocating tachycardia

(PJRT) in children.

METHODS: Twenty nine pediatric patients followed up with the diagnosis of PJRT in two pediatric

electrophysiology centers between 2011-2021 were included. The basic demographic characteristics

of the patients, electrocardiographic and echocardiographic findings were obtained retrospectively

from the file records. The medical treatment responses of the patients during the follow-up, the

electrophysiological study, and the ablation data of the patients who underwent electrophysiological

study were evaluated.

RESULTS: The mean age at diagnosis of the patients was 3.13±4.43(0-18) years and the mean weight

was 18.22±19.68kg (3.8-94). 62.1% of the patients were girls. At the time of admission, 11 patients

(37.9%) had tachycardia-induced cardiomyopathy (TIC) and their mean ejection fraction was

34±14%. In 15 (51.7%) patients, tachycardia was incessant and all patients except one received

medical treatment before ablation. 22 patients were using multidrug therapy (2 or more

antiarrhythmics). The most commonly used agents were amiodarone, beta-blockers, class 1 c drugs,

and their combinations. A total of 26 ablation procedures were required in 22 patients. The most

common indications for ablation were TİC and multidrug-resistant tachycardia. Accessory pathway

localization was right posteroseptal in 18 (81.81%) patients, the intracoronary sinus-middle cardiac

vein in 2 patients, midseptal in one patient, and posterior-posteroseptal oblique pathway in one

patient. The acute procedure success rate was 100%(22/22). The recurrence rate was 18% (4/22),

and three of them underwent successful ablation again. The overall success rate was %95.4 (21/22).

There were no complications in any of the patients. Cumulative success was 21/22 (95.4%). The

mean follow-up period was 4.39±3.05 years. The spontaneous resolution was observed in only 1 of

the 7 patients who were followed up clinically with antiarrhythmics, and 6 of the patients are still

under follow-up on medical therapy.

CONCLUSIONS: Although PJRT is rare, often incessant, resistant to medical treatment, and has a high

risk of developing TİC. In such patients, catheter ablation can be performed at any age with low

complication and high success rates. It is important to follow the patients in terms of recurrence.