The total absence of atrial automaticity in a child with sinus node dysfunction
Background A routine sports evaluation identified constant alternation between a junctional and idioventricular rhythm in a 9-year-old child. During exercise testing, electrography demonstrated that the child was in junctional rhythm without any apparent P waves, and had a reduced increase in heart rate. Endocardial atrial pacing captured the atrium and demonstrated that atrioventricular conduction was normal, but the recovery time of the ectopic rhythm was very long. Three-dimensional electrophysiological mapping revealed 1:1 retrograde homogeneous conduction through the right atrium. Investigations Electrocardiography, Holter monitoring, echocardiography, exercise stress testing, atrial p…
Closed loop stimulation improve ejection fraction in pediatric patients with pacemaker and ventricular dysfunction
Background: The aim of this prospective study was to evaluate the effect of the closed loop stimulation (CLS) on the ejection fraction in pediatric patients, affected by complete atrioventricular block (CAVB) or CAVB and sinus node dysfunction (SND), with a previously implanted pacemaker (PM) and ventricular dysfunction. The role of electrical therapy in the treatment of pediatric patients with congenital atrioventricular (AV) blocks has been shown. Conventional right ventricular pacing seems to affect ventricular function. Up to now, the feasibility and the long-term results of biventricular pacing in pediatric patients were not entirely clear. Methods: In eight pediatric patients with a p…
Transcatheter Ablation of Supraventricular Tachycardias in Pediatric Patients
Ablation has become an important treatment for many pediatric patients with common supraventricular tachycardias (SVTs). Many multicenter studies have documented that radiofrequency (RF) catheter ablation is a safe and effective procedure for treatment of a large variety of SVTs in children and adults with a high success rate and minimal complications. Novel electrophysiology technologies such as electroanatomic mapping and sophisticated ablating catheters have improved success rates and decreased complications of transcatheter ablation. Moreover, within the last several years, a new energy source using cryoenergy has evolved as a safe and effective alternative for catheter ablation for arr…