Abstract:
:Patients with anomalies of the heart frequently suffer from arrhythmias that either are associated with a congenital heart defect or result from the course of the disease. For most of the bradyarrhythmias, appropriate timing of the initiation of treatment is more challenging than its eventual execution. In the case of tachycardias, technical aspects of treatment require more attention because the often imperative impact such tachycardias have on quality of life, morbidity, and mortality determine intervention timing. Increasingly, interventional electrophysiology is turned to as a potentially definitive and substrate-related treatment because of antiarrhythmic drug therapy's failure to prevent arrhythmia recurrences and the potential detrimental side effects from drug therapy seen in this particular patient population. Using the experience gained during the past 10 years in the treatment of patients with arrhythmias but without associated structural heart disease, several groups reported their results and difficulties with the application of such therapy to patients with congenital heart defects. In this report, we summarize our hospital's experience with transcatheter radiofrequency current application for treatment of various types of tachyarrhythmias in 139 children and adults with congenital heart defects, emphasizing the current limitations of such therapy and addressing the potential benefits expected from future technology. Patient ages ranged from 5 months to 76 years (mean 25.3 +/- 17.7 years), including 56 children and adolescents less than 16 years of age. At least one attempt at surgical palliation or correction was made in 93 patients; the remaining 46 patients had no surgical intervention attempts. A total of 225 different tachycardias were found, 93 of which were based on a congenital arrhythmogenic substrate (e.g., an accessory pathway). Acquired substrates (e.g., scars or myocardial fibrosis) gave rise to the remaining 132 tachycardias. Radiofrequency current ablation (183 sessions) successfully treated 121 of 139 patients. Within a follow-up period of 21 months a recurrence of the intrinsically treated tachycardia was seen in 24 patients (10.7%); 13 of the 24 underwent a successful repeat session. There were no significant procedure-related complications. Young and adult patients with congenital heart disease can be safely and successfully treated for tachycardias with the use of radiofrequency current ablation. Because such treatment meets the specific needs of this patient group, early consideration for this therapy is recommended.
journal_name
Pediatr Cardioljournal_title
Pediatric cardiologyauthors
Hebe J,Hansen P,Ouyang F,Volkmer M,Kuck KHdoi
10.1007/s002460010134subject
Has Abstractpub_date
2000-11-01 00:00:00pages
557-75issue
6eissn
0172-0643issn
1432-1971pii
10.1007/s002460010134journal_volume
21pub_type
杂志文章,评审abstract::Various echocardiographic parameters are determined in the assessment and evaluation of a patent ductus arteriosus. In isolation, many of these parameters have a low sensitivity and specificity for ductal hemodynamic significance compared with ductal size. This study aimed to correlate various echocardiographic parame...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-013-0640-5
更新日期:2013-06-01 00:00:00
abstract::Intrathoracic ventricular aneurysms and diverticula can be differentiated by several criteria. Contractility is the only reliable parameter: aneurysms expand, whereas diverticula contract during ventricular systole. ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s002460010264
更新日期:2001-09-01 00:00:00
abstract::We encountered a male aged 6 years 4 months with Kawasaki disease (KD) with severe tricuspid regurgitation and left ventricular dysfunction in the acute phase. His clinical course and findings of endomyocardial biopsy suggested that myocarditis was the cause of left ventricular dysfunction and responsible for the deve...
journal_title:Pediatric cardiology
pub_type: 杂志文章,评审
doi:10.1007/s00246-002-0137-0
更新日期:2003-01-01 00:00:00
abstract::Persistent pulmonary hypertension of the newborn (PPHN) complicated with transposition of the great arteries (TGA) and an intact ventricular septum (IVS) often is therapy resistant and associated with an extremely poor prognosis. For this condition, opening of the ductus arteriosus (DA) by prostaglandin-E1 in conjunct...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-009-9475-5
更新日期:2009-10-01 00:00:00
abstract::We report a 4-month-old infant with torsade de pointes secondary to procainamide treatment. The infant presented with atrial flutter and converted to normal sinus rhythm with intravenous procainamide. Oral procainamide therapy was initiated as the infusion was tapered, and the patient subsequently developed incessant ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF00796823
更新日期:1995-03-01 00:00:00
abstract::Although transthoracic echocardiography (TTE) is the first-line examination for the study of coronary lesions in Kawasaki disease, CT coronary angiography (CTCA) is increasingly used and showed good results. Our aim is to evaluate the contribution of CTCA in the detection of coronary lesions and to compare its results...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-018-2044-z
更新日期:2019-02-01 00:00:00
abstract::Use of extracorporeal membrane oxygenation (ECMO) in infants with congenital heart disease is becoming more frequent. We present the first reported use of balloon atrial septostomy during ECMO support and describe possible complications of such procedures unique to ECMO therapy. ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF00795647
更新日期:1993-07-01 00:00:00
abstract::Various surgical techniques have been proposed for the repair of supravalvular pulmonary stenosis (SVPS) in pediatric populations. Whereas growth potential should be promised, excessive expansion under the presence of undiminished high pulmonary arterial pressure should be avoided. The authors applied all-autologous t...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-013-0698-0
更新日期:2013-10-01 00:00:00
abstract::The hybrid pathway for the management of patients with hypoplastic left heart syndrome was pioneered at our institution and is the preferred approach compared with the traditional Norwood pathway. Patients undergoing this surgery are generally <6 months of age, and pain management in this age group after surgery for c...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-012-0233-8
更新日期:2012-10-01 00:00:00
abstract::We report on a 4-kg infant with Alagille syndrome and congenital heart disease consisting of atrial septal defect (ASD), patent ductus arteriosus (PDA), and severe peripheral pulmonic stenosis. He underwent successful orthotopic liver transplant along with catheter closure of the ASD and PDA using the Amplatzer device...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:
更新日期:2002-11-01 00:00:00
abstract::Controversy exists as to whether a hemodynamically significant left-to-right shunt due to a patent ductus arteriosus (PDA) affects ventricular contractility. Load-dependent indices such as ejection fraction and shortening fraction have traditionally been used to assess contractility, but the relationship between the r...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-003-0452-0
更新日期:2004-03-01 00:00:00
abstract::Common arterial trunk is relatively a straightforward diagnosis on echocardiography. We describe a neonate who was referred to our centre as a case of common arterial trunk but on evaluation was found to have pulmonary atresia with ventricular septal defect and aortopulmonary window, for which he underwent repair with...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-012-0240-9
更新日期:2012-10-01 00:00:00
abstract::In other cardiomyopathies, cardiac magnetic resonance imaging (CMR)-derived myocardial delayed enhancement (MDE), a marker of myocardial fibrosis, is a risk factor for sudden cardiac death (SCD). In Duchenne muscular dystrophy (DMD), the prognostic value of MDE for ventricular arrhythmias and death is unknown. This st...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-014-0929-z
更新日期:2014-10-01 00:00:00
abstract::We describe the first report of an infant who was born with hypoplastic left heart syndrome and significant pulmonary stenosis. He was successfully palliated with multiple cardiac catheterization interventions while waiting for cardiac transplantation. This unusual constellation of heart defects is an entity that is r...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-004-0856-5
更新日期:2005-09-01 00:00:00
abstract::To evaluate the feasibility of implementing a pulse oximetry screening protocol at a city of mild elevation with a specific focus on the false-positive screening rate. Pulse oximetry screening was performed according to the proposed guidelines endorsed by the American Academy of Pediatrics at a center in Tucson, AZ, a...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-013-0716-2
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:This study aimed to provide descriptive information about off-label treatment practice with clopidogrel in a pediatric population. METHODS:Patients less than 18 years of age prescribed clopidogrel between March 2002 and August 2005 were retrospectively identified at Children's Hospital, Boston. Data from th...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-008-9289-x
更新日期:2009-02-01 00:00:00
abstract::The data on the outcomes of children with heart disease and Down syndrome receiving extracorporeal membrane oxygenation (ECMO) for cardiac or respiratory failure are limited. This study aimed to evaluate morbidity and mortality associated with ECMO in children with Down syndrome and heart disease. Children younger tha...
journal_title:Pediatric cardiology
pub_type: 杂志文章,多中心研究
doi:10.1007/s00246-014-0945-z
更新日期:2014-12-01 00:00:00
abstract::The original version of the article unfortunately contained an alignment error in Table 1. The correct version of Table 1 is given below. ...
journal_title:Pediatric cardiology
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00246-018-1978-5
更新日期:2019-01-01 00:00:00
abstract::We report a case of isolated ventricular inversion in a 42-year-old woman. This rare congenital cardiac anomaly was corrected by an intraatrial baffle procedure. She also underwent left-sided double-chamber endocardial pacemaker implantation for postoperative tachycardia bradycardia syndrome. ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-003-0583-3
更新日期:2004-09-01 00:00:00
abstract::Radiation exposure from pediatric cardiac catheterization may be substantial, although published estimates vary. We sought to report patient radiation dose across a range of diagnostic and interventional cases in a modern, high-volume pediatric catheterization laboratory. We retrospectively reviewed diagnostic and int...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-014-0869-7
更新日期:2014-06-01 00:00:00
abstract::For some congenital heart lesions, higher institutional surgical volume has been associated with better survival than in lower volume centers. The relationship between institutional surgical volume and mortality in infants after total anomalous pulmonary vein return (TAPVR) repair has not been well explored. The Texas...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-019-02224-x
更新日期:2020-01-01 00:00:00
abstract::Dexmedetomidine is a new sedative and analgesic agent that has a unique property of lack of respiratory depression. We describe a pediatric case in which the use of dexmedetomidine enabled us to successfully extubate a 12-year-old heart transplant patient with acute pneumonia after several failed attempts with the use...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-005-0683-3
更新日期:2005-09-01 00:00:00
abstract::This prospective observational study conducted in a neonatal intensive care unit aimed to evaluate echocardiographic changes provoked by anemia and transfusion of packed red blood cells (pRBCs) in premature infants. In this study, 32 anemic premature infants had serial echocardiographic assessment of left ventricular ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-012-0154-6
更新日期:2012-04-01 00:00:00
abstract::Killian-Pallister syndrome is a rare dysmorphic condition characterized by specific clinical manifestations and tetrasomy 12p. Although the association of this condition with congenital heart disease has been previously documented, no cases have been reported in association with Fallot's tetralogy. We report one such ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s002469900420
更新日期:1999-03-01 00:00:00
abstract::Interventional occluder implantation has become the preferred mode of treatment in children with clinically significant atrial septal defect (ASD). The continuous increase in the number of patients treated calls for long-term data on device integrity and biocompatibility. We report a child who underwent successful int...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-010-9757-y
更新日期:2010-10-01 00:00:00
abstract::Human pluripotent stem cells (hPSCs) offer a multifaceted platform to study cardiac developmental biology, understand disease mechanisms, and develop novel therapies. Remarkable progress over the last two decades has led to methods to obtain highly pure hPSC-derived cardiomyocytes (hPSC-CMs) with reasonable ease and s...
journal_title:Pediatric cardiology
pub_type: 杂志文章,评审
doi:10.1007/s00246-019-02165-5
更新日期:2019-10-01 00:00:00
abstract::Catheter ablation in children requires placement of multiple large femoral venous sheaths and catheters. Magnetic resonance angiography (MRA) was used to evaluate the effect of indwelling lines on femoral venous blood flow. Between October 1993 and February 1994 a total of 17 patients scheduled for catheter ablation u...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s002469900151
更新日期:1997-05-01 00:00:00
abstract::The genetic basis of congenital heart disease remains unknown in most of the cases. Recently, a novel mouse model shed new light on the role of CCN1/CYR61, a matricellular regulatory factor, in cardiac morphogenesis. In a candidate gene approach, we analyzed a cohort of 143 patients with atrial septal defects (ASD) by...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-014-1001-8
更新日期:2015-02-01 00:00:00
abstract::The nuclear cross-sectional area of the muscular fibers from a series of myocardial bridges was analyzed and compared to both the adjacent and underlying myocardial fibers. The series came from 12 hearts of children, ranging in age from 24 h to 2 years, with diverse forms of congenital heart disease, which caused left...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF02238364
更新日期:1990-10-01 00:00:00
abstract::Digoxin has been an effective treatment for fetal supraventricular tachycardia (SVT), but second-line therapy remains more controversial. Thirty-seven cases of fetal SVT were identified that received digoxin as first-line therapy. Seventeen fetuses (46%) converted to and maintained normal sinus rhythm. Flecainide was ...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s002460010279
更新日期:2001-11-01 00:00:00