Document Detail


Long-term follow-up of arrhythmias in pediatric orthotopic heart transplant recipients: incidence and correlation with rejection.
MedLine Citation:
PMID:  12909469     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Arrhythmias in adult orthotopic heart transplant (OHT) recipients are common and have been used as predictors of rejection. Because of the paucity of information in pediatric OHT recipients, the purpose of this study was to determine the incidence and correlation of arrhythmias with rejection or with coronary artery disease (CAD) in children. METHODS: We retrospectively reviewed the records, electrocardiograms (ECGs), and 24-hour ambulatory ECGs of patients who underwent OHT from January 1984 to December 1999. We excluded arrhythmias occurring in the first 2 weeks after OHT. RESULTS: Sixty-nine patients underwent OHT, received triple-immunosuppression therapy, were discharged home, and have been followed for a mean of 4.7 years (0.3-13 years). Each patient had an average of 10 ECGs and three 24-hour ECGs. Twenty-six patients had 33 arrhythmias: sinus bradycardia (n = 9), atrial tachycardia (n = 9), ventricular tachycardia (n = 3), and Wenckebach periodicity (n = 6). Sinus bradycardia was treated with theophylline in 8 patients, and 2 required pacemakers. Atrial tachycardias (atrial flutter in 4 patients and atrial ectopic tachycardia in 5) were treated with digoxin, propranolol, or procainamide. Ventricular tachycardia was treated with mexiletine, lidocaine, and amiodarone. There were 65 episodes of rejection, 20 of which were moderate/severe (> or =3B). Only Wenckebach was associated with the presence of either rejection or CAD (p < 0.05). CONCLUSIONS: We noted clinically significant arrhythmias in 38% of the pediatric OHT recipients. Sinus bradycardia, atrial tachyarrhythmias, and ventricular tachycardia occurred with the same frequency. Only new-onset Wenckebach periodicity was noted in the presence of either CAD or rejection. No arrhythmia was of negative predictive value for rejection or CAD. From this data, we suggest that new-onset Wenckebach prompt evaluation for rejection or CAD.
Authors:
N J Kertesz; J A Towbin; S Clunie; A L Fenrich; R A Friedman; D L Kearney; W J Dreyer; J F Price; B Radovancevic; S W Denfield
Related Documents :
3216179 - A computer model of the electrogram: what causes fractionation?
3628329 - Circadian rhythm of ventricular tachycardia.
1707219 - A new method for estimating preexcitation index without extrastimulus technique and its...
8746959 - Peripartum heart disease in cows.
10709239 - Orthodromic tachycardia with atrioventricular dissociation: evidence for a nodoventricu...
665509 - Clinical, electrocardiographic and electrophysiologic observations in patients with par...
21244879 - Toward a molecular view of cardiac arrhythmogenesis.
18430909 - Comparison of an everolimus-eluting stent and a paclitaxel-eluting stent in patients wi...
23979779 - Pulmonary arterial hypertension: use of delayed contrast-enhanced cardiovascular magnet...
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  22     ISSN:  1053-2498     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-11     Completed Date:  2004-01-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  889-93     Citation Subset:  IM    
Affiliation:
Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA. kertesz@bcm.tmc.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Arrhythmias, Cardiac / complications*,  epidemiology*,  physiopathology
Child
Child, Preschool
Coronary Artery Disease / complications,  diagnosis,  physiopathology
Electrocardiography
Follow-Up Studies
Graft Rejection / complications*,  diagnosis,  physiopathology
Heart Transplantation*
Humans
Incidence
Infant
Infant, Newborn
Predictive Value of Tests
Retrospective Studies
Time Factors

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


Previous Document:  Scoring system to determine need for balloon atrial septostomy for restrictive interatrial communica...
Next Document:  Weight gain after lung transplantation.