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  • Title: Permanent junctional reciprocating tachycardia in infants and children: effectiveness of medical and non-medical treatment.
    Author: Drago F, Silvetti MS, Mazza A, Anaclerio S, Pino AD, Grutter G, Bevilacqua M.
    Journal: Ital Heart J; 2001 Jun; 2(6):456-61. PubMed ID: 11453583.
    Abstract:
    BACKGROUND: The aim of this study was to identify, in children affected by permanent junctional reciprocating tachycardia (PJRT), the effective treatment. METHODS: Seventeen children (9 males, 8 females, mean age 59 +/- 62 months, median 24) affected by PJRT were referred to our Institute between the years 1987 and 2000. RESULTS: Pharmacological therapy was successfully used in 14 patients: flecainide and propranolol in 5 of them, amiodarone alone in 5 and associated with propranolol in 2, propafenone alone in 1 and in association with sotalol in 1. These drugs were given for a mean period of 54.5 +/- 49.8 months with resolution of the cardiomyopathy in 7/7 patients. Treatment had been continued for 3-6 months and there were no side effects. Nine patients were treated with radiofrequency transcatheter ablation, after 78 +/- 53.5 months of medical treatment, at a mean age of 150 +/- 16 months. The shortest endocardial ventriculo-atrial (VA) interval during tachycardia was recorded in all cases at the coronary sinus ostium (mean value of local VA-surface RP' interval -38 ms, range -24/-55 ms). Successful ablation of the anomalous pathway was obtained at this site in all patients (mean watts delivered 26 +/- 3 W, mean T degrees 64 +/- 5 degrees C). During the follow-up period (mean 21 +/- 17 months) 2 patients with recurrences of PJRT underwent a second successful procedure. CONCLUSIONS: PJRT in pediatric patients can be successfully treated with antiarrhythmic drugs, this may allow delay of the highly effective radiofrequency ablation treatment until the children have reached an adequate growth.
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