THE CLINICAL AND
ELECTROPHYSIOLOGICAL CHARACTERISTICS IN CHILDREN WITH ATRIOVENTRICULAR
NODAL REENTRANT TACHYCARDIA
Pi-Chang Lee1, Shih-Ann Chen2, Betau Hwang1
Department of Pediatrics1 and Medicine2,
Taipei Veterans General Hospital and National Yang-Ming University, Chinese
Taipei
Objective:
Atrioventricular
(AV) nodal reentrant tachycardia is well known to be one of the most common
supraventricular tachycardia in childhood. However, the information about
AV nodal reentrant tachycardia in childhood is limited, especially about the
variant and multiple forms. The purpose of this study is to investigate the
clinical and electrophysiologic characteristics in pediatric patients with
AV nodal reentrant tachycardia.
Methods: Forty-eight pediatric
patients with AV nodal reentrant tachycardia were studied (age: 11-18 years;
M/F = 25: 23) to evaluate the electrophysiologic characteristics by using
atrial and ventricular incremental pacing and extrastimulation.
Results: The onset and duration of symptoms were significant
younger and shorter in pediatric patients. A higher incidence of antegrade
dual AV nodal pathways in adult patients with AV nodal reentrant
tachycardia was demonstrated (p = 0.003). Both antegrade and retrograde ERP
of slow pathway in adult patients were longer than those in pediatric
patients (p = 0.002 and 0.015). The occurrence of variant and multiple
forms of AV nodal reentrant tachycardia was no significant difference
between children and adults.
Conclusion: The study demonstrated that the pediatric
patients have different electrophysiologic characteristics from the adult
patients, and radiofrequency ablation is reliable and valuable to treat AV
nodal reentrant tachycardia in children.