Usefulness of transtelephonic monitoring in epicardial pacemaker systems.

Background: Transtelephonic monitoring (TTM) of pediatric patients with cardiac pacemakers (PMs) has been shown to have high sensitivity and specificity in identifying PM malfunction. The objective of this study is to determine if there is a difference in the rate of abnormal TTM findings in transvenous versus epicardial PM systems.

Methods: Our TTM database was reviewed.

Relation of the utility of exercise testing for risk assessment in pediatric patients with ventricular preexcitation to pathway location.

The gradual loss of ventricular preexcitation during exercise stress testing (EST) has an unclear risk of an association with life-threatening arrhythmia and could be related to the accessory pathway (AP) location. We compared the loss of preexcitation during EST with the risk assessment during invasive electrophysiology testing and determined whether the loss of preexcitation correlates with the AP location. We retrospectively reviewed patients aged ≤21 years with ventricular preexcitation who had undergone both EST and an electrophysiology study.

Ablation of supraventricular tachycardia allows more liberal therapy in some children with attention-deficit-hyperactivity disorder.

Background: First-line therapy for children with attention-deficit-hyperactivity disorder (ADHD) is stimulant medication, which may have potential cardiovascular side-effects. In patients with supraventricular tachycardia or Wolf-Parkinson-White syndrome (WPW), therapy for ADHD could become challenging. The purpose of the present study was to review the authors' experience of performing electrophysiologic study (EPS) with or without ablation to determine how it affected ADHD therapy.

Predictors for hemodynamic improvement with temporary pacing after pediatric cardiac surgery.

Objectives: Temporary epicardial pacing wires are commonly placed during pediatric cardiac surgery. Data are sparse on postoperative pacing in this population. The objective of this study was to determine the frequency of use and identify predictors for the use of temporary epicardial pacing wires.

Coronary artery spasm during radiofrequency ablation of a left lateral accessory pathway.

A 16-year-old female patient with Wolff-Parkinson-White syndrome and supraventricular tachycardia underwent radiofrequency (RF) catheter ablation of an accessory pathway in the left lateral area. During RF ablation she developed reversible ST segment elevation secondary to coronary artery spasm. Coronary angiography demonstrated the ablation catheter in close proximity to the circumflex coronary artery, with no evidence of coronary artery injury.