Lone Atrial Fibrillation in the Young - Perhaps Not So ¡°Lone¡±?

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• 作者：Scott R. Ceresnak ; MD¹ ; ^{ceresnak@yahoo.com} ; Leonardo Liberman ; MD² ; Eric S. Silver ; MD² ; Steven B. Fishberger ; MD³ ; Gregory J. Gates ; PhD⁴ ; Lynn Nappo ; RN¹ ; Joseph Mahgerefteh ; MD¹ ; Robert H. Pass ; MD¹
• 关键词：AF ; Atrial fibrillation ; AVNRT ; Atrioventricular nodal re-entry tachycardia ; AVRT ; Atrioventricular re-entry tachycardia ; BMI ; Body mass index ; EAT ; Ectopic atrial tachycardia ; EP ; Electrophysiology ; RF ; Radiofrequency ; SVT ; Supraventricular tachycardia
• 刊名：The Journal of Pediatrics
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：162
• 期：4
• 页码：827-831
• 全文大小：436 K

文摘

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Objective

To determine if pediatric patients with a history of lone atrial fibrillation (AF) have other forms of supraventricular tachycardia (SVT) that may potentially trigger AF.

Study design

A multicenter review of patients with lone AF who underwent electrophysiology (EP) study from 2006-2011 was performed. Inclusion criteria: age ¡Ü21 years, normal ventricular function, structurally normal heart, history of AF, and EP study and/or ablation performed. Exclusion criteria: congenital heart disease or cardiomyopathy. Patient demographics, findings at EP study and follow-up data were recorded.

Results

Eighteen patients met inclusion criteria. The mean age was 17.9?¡À?2.2 years, weight was 82?¡À?21 kg, body mass index was 27?¡À?6, and 15 (83 % ) were males. Eleven (61 % ) were overweight or obese. Seven (39 % ) had inducible SVT during EP study: 5 atrioventricular nodal re-entry tachycardia (71 % ) and 2 concealed accessory pathways with inducible atrioventricular re-entry tachycardia (29 % ). All 7 patients with inducible SVT underwent radiofrequency ablation. There were no complications during EP study and/or ablation for all 18 patients. The mean follow-up was 1.7?¡À?1.5 years and there were no recurrences in the 7 patients who underwent ablation. There were 2 recurrences of AF in patients with no other form of SVT during EP study.

Conclusions

Inducible SVT was found in 39 % of pediatric patients undergoing EP study for lone AF. EP study should be considered for pediatric patients presenting with lone AF.