Document Detail

Clinical use of permanent pacemaker for conversion of intraatrial reentry tachycardia in children.
MedLine Citation:
PMID:  11449591     Owner:  NLM     Status:  MEDLINE    
The use of the implanted atrial-based pacemaker to overdrive postsurgical intraatrial reentry tachycardia (IART) was evaluated in a large group of pediatric patients over a 14-year study period. The authors sought to determine the feasibility of this noninvasive technique in the management of this specialized population and to determine factors associated with successful conversion. They examined 128 manual overdrive attempts performed on 22 consecutive patients. There were 10 patients with post-Fontan repair, 7 with post-Mustard/Senning procedure, and 5 with miscellaneous lesion types. The number of IART episodes for overdrive pacing per patient ranged from 1 to 15. The first overdrive pacing attempt was successful in 63% (14/22) of the patients. The mean IART cycle length was 278 +/- 59 ms. The mean pacing rate for effective conversion of IART was 66 +/- 10% faster than the IART rate. By controlling for repeated measures for individual patients, three factors were found to be independently associated with a successful outcome: (1) lesion type other than Fontan surgery (P = 0.007), (2) lack of acceleration of IART with the overdrive attempt (P < 0.001), and (3) patient use of amiodarone with attempt (P = 0.005). There were three procedural complications: two inadvertent overdrive pacing episodes, and one episode of acceleration of IART cycle length and conduction resulting in need for cardioversion. Manual pacemaker overdrive conversion of IART is a useful adjunct in the management of postsurgical IART in the pediatric population and should be considered as an initial treatment option.
C C Chiu; B W McCrindle; R M Hamilton; J E Griffiths; R M Gow
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  24     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-07-13     Completed Date:  2002-05-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  950-6     Citation Subset:  IM    
Division of Cardiology, Department of Pediatrics, University of Toronto, Hospital for Sick Children, Toronto, Canada.
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MeSH Terms
Cardiac Pacing, Artificial / methods*
Child, Preschool
Equipment Design
Feasibility Studies
Heart Atria / physiopathology
Pacemaker, Artificial*
Tachycardia / therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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