Document Detail


Transesophageal study of recurrent atrial tachycardia after atrial baffle procedures for complete transposition of the great arteries.
MedLine Citation:
PMID:  3717037     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Transesophageal study was used for diagnosis and treatment of 51 episodes of tachycardia in 13 patients with complete transposition of the great arteries who had undergone atrial baffle procedure. At the time of atrial baffle procedure, patients were 6 to 36 months old (mean 23). Tachycardia (1 to 17 episodes per patient) first occurred 1 to 23 days (4 patients) or 1.8 to 12 years (9 patients) after atrial baffle. Transesophageal study was performed using a bipolar silicone rubber-coated catheter. Tachycardia conversion was accomplished with stimulation bursts using 4 to 10 stimuli 9.9 ms in duration at 20 to 28 mA and an interstimulus interval of 50 to 100 ms less than the atrial cycle length. All tachycardia episodes had regular atrial cycle lengths ranging from 200 to 350 ms. In 12 patients, second-degree atrioventricular (AV) block was observed during tachycardia, suggesting primary atrial tachycardia. However, in 1 patient, occurrence of AV block always resulted in tachycardia termination, suggesting the presence of AV reentrant tachycardia. Transesophageal stimulation converted 48 of 51 tachycardia episodes to sinus/junctional rhythm. Ten tachycardia episodes in 6 patients were transiently converted to atrial fibrillation lasting 3 seconds to 28 minutes before spontaneous conversion to sinus junctional rhythm. Conversion attempts were unsuccessful on 3 occasions. Acceleration of ventricular rate after stimulation necessitated DC cardioversion on 1 occasion. Conversion was not achieved in 2 tachycardia episodes using stimuli less than 10 mA. Transesophageal study is a safe and effective minimally invasive technique for diagnosis and treatment of tachycardia in infants and children who have had atrial baffle for transposition of the great arteries.
Authors:
F Butto; A Dunnigan; E D Overholt; D G Benditt; D W Benson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  57     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1986 Jun 
Date Detail:
Created Date:  1986-06-27     Completed Date:  1986-06-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1356-62     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Child, Preschool
Electrocardiography
Electrophysiology
Female
Heart Atria / surgery
Humans
Infant
Male
Recurrence
Tachycardia / diagnosis*,  physiopathology,  therapy
Transposition of Great Vessels / surgery

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


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