Atrial tachycardia from enhanced automaticity in children: diagnosis and initial management.

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dc.contributor.authorKhongphatthanayothin, Aen_US
dc.contributor.authorChotivitayatarakorn, Pen_US
dc.contributor.authorLertsupcharoen, Pen_US
dc.contributor.authorMuangmingsuk, Sen_US
dc.contributor.authorThisyakorn, Cen_US
dc.date.accessioned2009-05-27T21:10:48Z
dc.date.available2009-05-27T21:10:48Z
dc.date.issued2001-09-22en_US
dc.descriptionChotmaihet Thangphaet.en_US
dc.description.abstractTen patients (aged 0-9 years) with the diagnosis of automatic atrial tachycardia (AAT) from August 1997 to August 2000 were reviewed. Three patients had paroxysmal (repetitive) AAT and the tachycardia was incessant in six (defined as presence of AAT for more than 90% of the time). The type of AAT in one patient was unknown. Four patients presented with congestive heart failure (CHF), one with pre-syncope, one with palpitation, and four were asymptomatic. Six patients (60%) had depressed left ventricular ejection fraction. All patients with CHF had incessant AAT with atrial rate > 220/min and ventricular rate > 200/min at admission. After treatment with antiarrhythmic medications, all patients had adequate control of the AAT (9 had complete elimination of AAT and 1 partial control). Amiodarone (alone, or in combination with digoxin) was effective in 5 of 6 cases (83%), although complete elimination of the AAT was usually delayed (median = 5 days, range 30 minutes to 17 days). Other effective medications were digoxin, digoxin + propranolol and atenolol (all in patients who did not have CHF on presentation). At the time of this report, 3 patients had no AAT off antiarrhythmic medication, 5 patients were still receiving treatment (with good control) and 2 patients died from sepsis during the same admission even though AAT was controlled. All surviving patients had normal ventricular ejection fraction on follow-up. AAT in children is rare, but when it occurs in persistent form at a fast rate, it is usually associated with CHF and is difficult to treat. Amiodarone (+/- digoxin) effectively controls the arrhythmia in the majority of cases, although full effect may take several days. With successful treatment, most patients do well and some can be taken off the medication(s) without recurrence of the arrhythmia.en_US
dc.description.affiliationDepartment of Pediatrics, Faculy of Medicine, Chulalongkorn University, Bangkok, Thailand.en_US
dc.identifier.citationKhongphatthanayothin A, Chotivitayatarakorn P, Lertsupcharoen P, Muangmingsuk S, Thisyakorn C. Atrial tachycardia from enhanced automaticity in children: diagnosis and initial management. Journal of the Medical Association of Thailand. 2001 Sep; 84(9): 1321-8en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/44335
dc.language.isoengen_US
dc.source.urihttps://www.mat.or.th/journal/all.phpen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAge Factorsen_US
dc.subject.meshAnti-Arrhythmia Agents --administration & dosageen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshElectrocardiographyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Function Testsen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshInfant, Newbornen_US
dc.subject.meshMaleen_US
dc.subject.meshProbabilityen_US
dc.subject.meshPrognosisen_US
dc.subject.meshRisk Assessmenten_US
dc.subject.meshSeverity of Illness Indexen_US
dc.subject.meshSex Factorsen_US
dc.subject.meshSurvival Analysisen_US
dc.subject.meshTachycardia, Ectopic Atrial --diagnosisen_US
dc.subject.meshThailanden_US
dc.subject.meshTreatment Outcomeen_US
dc.titleAtrial tachycardia from enhanced automaticity in children: diagnosis and initial management.en_US
dc.typeJournal Articleen_US
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