Arrhythmias in Children Clinical Course of Atrial Ectopic Tachycardia Is Age-Dependent: Results and Treatment in Children 3o r3 Years of Age

OBJECTIVES We assessed the clinical presentation, natural history, and treatment response of atrial ectopictachycardia (AET) in children 3 years of age (group 1) compared with those 3 years ofage (group 2).BACKGROUND Atrial ectopic tachycardia is a common cause of chronic supraventricular tachycardia inchildren and can be resistant to pharmacologic therapy. Radiofrequency ablation (RFA) caneliminate AET arising from a single focus.METHODS A retrospective review identified all children at Texas Children’s Hospital diagnosed withAET from March 1991 to November 2000. Data obtained included clinical presentation,echocardiographic evaluation, response to antiarrhythmic therapy, spontaneous resolution,and outcomes of radiofrequency and surgical ablation.RESULTS Sixty-eight children were identified (22 children 3 years and 46 children 3 years of age).Control of AET with antiarrhythmic therapy was achieved in 91% of the younger childrenbut only 37% of the older children (p 0.001). There was a higher rate of spontaneousresolution in the younger group (78%) compared with the older group (16%) (p 0.001).Radiofrequency ablation was performed in 35 of the older children, with ultimate success in74%. Surgical intervention was required for six children.CONCLUSIONS Younger children respond to antiarrhythmic therapy and have a high incidence of AETresolution, thus warranting a trial of antiarrhythmic therapy. In children 3 years, AET isunlikely to resolve spontaneously, and antiarrhythmic medications are frequently ineffective.Thus, RFA should be considered early in the course of treatment for these children; however,surgical intervention may be necessary. (J Am Coll Cardiol 2004;43:438–44) © 2004 bythe American College of Cardiology Foundation