Supraventricular arrhythmias in children and young adults with implantable cardioverter defibrillators.
Introduction: Rapidly conducted supraventricular tachycardias (SVTs) can lead to inappropriate device therapy in implantable cardioverter defibrillator (ICD) patients. We sought to determine the incidence of SVTs and the occurrence of inappropriate ICD therapy due to SVT in a pediatric and young adu...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 12; no. 10; pp. 1097 - 1102 |
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| Autores principales: | , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2001
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106088831&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106088831 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Oct2001 vid: 12 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106088831 106088831 2009418589 10.1046/j.1540-8167.2001.01097.x NLM11699514 106088831 ppf: 1097 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Supraventricular arrhythmias in children and young adults with implantable cardioverter defibrillators. aug: au: Love BA Barrett KS Alexander ME Bevilacqua LM Epstein MR Triedman JK Walsh EP Berul CI sug: subj: Defibrillators, Implantable Adverse Effects Tachycardia, Supraventricular Therapy Adolescence Adrenergic beta-Antagonists Therapeutic Use Adult Age Factors Algorithms Antiarrhythmia Agents Therapeutic Use Catheter Ablation Child Welfare Child Child, Preschool Equipment Failure Female Heart Function Tests Infant Male Massachusetts Middle Age Prevalence Prospective Studies Retrospective Design Tachycardia, Supraventricular Complications Tachycardia, Supraventricular Diagnosis Treatment Outcomes Ventricular Fibrillation Complications Ventricular Fibrillation Diagnosis Ventricular Fibrillation Therapy Human Adolescent: 13-18 years Adult: 19-44 years Child: 6-12 years Child, Preschool: 2-5 years Infant: 1-23 months Middle Aged: 45-64 years Female Male ab: Introduction: Rapidly conducted supraventricular tachycardias (SVTs) can lead to inappropriate device therapy in implantable cardioverter defibrillator (ICD) patients. We sought to determine the incidence of SVTs and the occurrence of inappropriate ICD therapy due to SVT in a pediatric and young adult population. Methods and Results: We undertook a retrospective review of clinical course, Holter monitoring, and ICD interrogations of patients receiving ICD follow-up at our institution between March 1992 and December 1999. Of 81 new ICD implantations, 54 eligible patients (median age 16.5 years, range 1 to 48) were identified. Implantation indications included syncope and/or spontaneous/inducible ventricular arrhythmia with congenital heart disease (30), long QT syndrome (9), structurally normal heart (ventricular tachycardia/ventricular fibrillation [VT/VF]) (7), and cardiomyopathies (7). Sixteen patients (30%) received a dual-chamber ICD. SVT was recognized in 16 patients, with 12 of 16 having inducible or spontaneous atrial tachycardias. Eighteen patients (33%) received >=1 appropriate shock(s) for VT/VF; 8 patients (15%) received inappropriate therapy for SVT. Therapies were altered after an inappropriate shock by increasing the detection time or rate and/or increasing beta-blocker dosage. No single-chamber ICD was initially programmed with detection enhancements, such as sudden onset, rate stability, or QRS discriminators. Only one dual-chamber defibrillator was programmed with an atrial discrimination algorithm. Appropriate ICD therapy was not withheld due to detection parameters or SVT discrimination programming. Conclusion: SVT in children and young adults with ICDs is common. Inappropriate shocks due to SVT can be curtailed even without dual-chamber devices or specific SVT discrimination algorithms. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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