Author + information
- Received August 4, 2008
- Revision received November 12, 2008
- Accepted November 16, 2008
- Published online February 24, 2009.
- Kathryn K. Collins, MD, FACC⁎,⁎ (, )
- George F. Van Hare, MD, FACC†,‡,††,
- Naomi J. Kertesz, MD, FACC§,
- Ian H. Law, MD, FACC∥,
- Yaniv Bar-Cohen, MD, FACC¶,
- Anne M. Dubin, MD, FACC‡,
- Susan P. Etheridge, MD, FACC#,
- Charles I. Berul, MD, FACC⁎⁎,
- Jennifer N. Avari, MD††,
- Volkan Tuzcu, MD‡‡,
- Narayanswami Sreeram, MD§§,
- Michael S. Schaffer, MD⁎,
- Anne Fournier, MD, FACC∥∥,
- Shubhayan Sanatani, MD¶¶,
- Christopher S. Snyder, MD##,
- Richard T. Smith Jr, MD, FACC⁎⁎⁎,
- Luis Arabia, MD†††,
- Robert Hamilton, MD‡‡‡,
- Terrence Chun, MD§§§,
- Leonardo Liberman, MD∥∥∥,
- Bahram Kakavand, MD, FACC¶¶¶,
- Thomas Paul, MD, FACC### and
- Ronn E. Tanel, MD⁎⁎⁎⁎
- ↵⁎Reprint requests and correspondence:
Dr. Kathryn K. Collins, The Children's Hospital, Section of Cardiology/B100, 13123 E. 16th Avenue, Aurora, Colorado 80045
Objectives To determine the outcomes of medical management, pacing, and catheter ablation for the treatment of nonpost-operative junctional ectopic tachycardia (JET) in a pediatric population.
Background Nonpost-operative JET is a rare tachyarrhythmia that is associated with a high rate of morbidity and mortality. Most reports of clinical outcomes were published before the routine use of amiodarone or ablation therapies.
Methods This is an international, multicenter retrospective outcome study of pediatric patients treated for nonpost-operative JET.
Results A total of 94 patients with JET and 5 patients with accelerated junctional rhythm (age 0.8 year, range fetus to 16 years) from 22 institutions were identified. JET patients presenting at age ≤6 months were more likely to have incessant JET and to have faster JET rates. Antiarrhythmic medications were utilized in a majority of JET patients (89%), and of those, amiodarone was the most commonly reported effective agent (60%). Radiofrequency ablation was conducted in 17 patients and cryoablation in 27, with comparable success rates (82% radiofrequency vs. 85% cryoablation, p = 1.0). Atrioventricular junction ablation was required in 3% and pacemaker implantation in 14%. There were 4 (4%) deaths, all in patients presenting at age ≤6 months.
Conclusions Patients with nonpost-operative JET have a wide range of clinical presentations, with younger patients demonstrating higher morbidity and mortality. With current medical, ablative, and device therapies, the majority of patients have a good clinical outcome.
Dr. Collins is a speaker for St. Jude Medical. Dr. Dubin receives fellowship support from Medtronic. Dr. Berul is a consultant for Johnson & Johnson and Novartis. Dr. Tuzcu is a consultant for St. Jude Medical. Dr. Santani has received an unrestricted grant for research from Medtronic. Dr. Law is a speaker for Cryocath.
- Received August 4, 2008.
- Revision received November 12, 2008.
- Accepted November 16, 2008.
- American College of Cardiology Foundation