https://scholars.lib.ntu.edu.tw/handle/123456789/536758
標題: | Supraventricular tachycardia in patients with right atrial isomerism | 作者: | MEI-HWAN WU JOU-KOU WANG JIUNN-LEE LIN LING-PING LAI Lue H.-C. Young M.-L. FON-JOU HSIEH |
公開日期: | 1998 | 卷: | 32 | 期: | 3 | 起(迄)頁: | 773-779 | 來源出版物: | Journal of the American College of Cardiology | 摘要: | Objectives. To clarify the prevalence and mechanism of supraventricular tachycardia in patients with fight atrial isomerism. Background. Paired SA and dual atrioventricular (AV) nodes have been described in patients with right atrial isomerism. However, the clinical significance remains unclear. Methods. From 1987 to 1996, a total of 101 patients (61 male, 40 female) and four fetuses were identified with right atrial isomerism. The diagnosis of supraventricular tachycardia exclude the tachycardia with prolonged QRS duration or AV dissociation, and primary atrial tachycardia. Results. The median follow-up duration was 38 months (range 0.2-270 months). Supraventricular tachycardia was documented in 25 patients (24.8%) and one fetus (25%) (onset age ranged from prenatal to 14 years old; median 4 years old). Actuarial Kaplan-Meier analysis revealed that the probability of being free from tachycardia was 67% and 50% at 6 and 10 years of age, respectively. These tachycardias could be converted by vagal maneuvers in one, verapamil in seven, propranolol in four, digoxin in two, procainamide in one, and rapid pacing in five. Spontaneous conversion was noted in six (including the fetus). Seven cases had received electrophysiologicaI studies. Reciprocating AV tachycardia could be induced in five and echo beats in one. The tachycardia in three patients was documented as incorporating a posterior AV node (antegrade) and an anterior or a lateral AV node (retrograde). Two of them received radiofrequency ablation. Successful ablation in both was obtained by delivering energy during tachycardia, aimed at the earliest retrograde atrial activity and accompanied by junctional ectopic rhythm. The patient with echo beats developed tachycardia soon after operation. Conclusions. Supraventricular tachycardia is common in patients with right atrial isomerism and can occur during the prenatal stage. Drugs to slow conduction through the AV node may help to terminate the tachycardia. Radiofrequency ablation is a safe and effective treatment alternative to eliminate tachycardia. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0031667046&doi=10.1016%2fS0735-1097%2898%2900307-6&partnerID=40&md5=7bd41a8e19e10c34e0a25539c591f44d https://scholars.lib.ntu.edu.tw/handle/123456789/536758 |
ISSN: | 0735-1097 | DOI: | 10.1016/S0735-1097(98)00307-6 | SDG/關鍵字: | digoxin; procainamide; propranolol; verapamil; article; automatic cardioversion; catheter ablation; child; congenital heart malformation; female; fetus; follow up; heart atrioventricular node; heart pacing; human; lung vein drainage anomaly; major clinical study; male; newborn; onset age; prevalence; priority journal; qrs complex; reentry tachycardia; sinus node; supraventricular tachycardia; surgical mortality; transluminal valvuloplasty; Actuarial Analysis; Adolescent; Anti-Arrhythmia Agents; Atrioventricular Node; Cardiac Pacing, Artificial; Child; Child, Preschool; Combined Modality Therapy; Electrocardiography; Female; Follow-Up Studies; Heart Defects, Congenital; Humans; Infant; Infant, Newborn; Male; Pregnancy; Prognosis; Recurrence; Sinoatrial Node; Survival Rate; Tachycardia, Supraventricular |
顯示於: | 醫學系 |
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