Management and outcomes of atrial fibrillation in 241 healthy children and young adults: Revisiting "lone" atrial fibrillation-A multi-institutional PACES collaborative study.

Background: Atrial fibrillation (AF) in healthy children and young adults is rare. Risk of recurrence and treatment efficacy are not well defined.

Objective: The purpose of this study was to assess recurrence patterns and treatment efficacy in AF.

Loss of ventricular preexcitation during noninvasive testing does not exclude high-risk accessory pathways: A multicenter study of WPW in children.

Background: Abrupt loss of ventricular preexcitation on noninvasive evaluation, or nonpersistent preexcitation, in Wolff-Parkinson-White syndrome (WPW) is thought to indicate a low risk of life-threatening events.

Objective: The purpose of this study was to compare accessory pathway (AP) characteristics and occurrences of sudden cardiac arrest (SCA) and rapidly conducted preexcited atrial fibrillation (RC-AF) in patients with nonpersistent and persistent preexcitation.

Methods: Patients 21 years or younger with WPW and invasive electrophysiology study (EPS) data, SCA, or RC-AF were identified from multicenter databases.

Troponin elevation in the setting of exercise-induced rhabdomyolysis in an athletic teenager.

Troponin levels are often obtained when chest pain is evaluated in the paediatric emergency department. Elevations in troponin levels can be due to different causes, and it is important to fully understand all of these possible causes to help streamline further evaluation and therapy. We present the case of a teenager who had two episodes of troponin elevation in the setting of rhabdomyolysis.

Ventricular pacing in single ventricles-A bad combination.

Background: Chronic ventricular pacing (VP) is associated with systolic dysfunction in a subset of pediatric patients with heart block and structurally normal hearts. The effect of chronic VP in congenital heart disease is less well understood, specifically in the single-ventricle (SV) population.

Objective: To determine the longitudinal effect of VP in SV patients.

Use of dofetilide in adult patients with atrial arrhythmias and congenital heart disease: A PACES collaborative study.

Background: Arrhythmia management has become the major treatment challenge in adult patients with congenital heart disease (ACHD).

Objective: We sought to investigate the utility and safety profile of dofetilide for atrial arrhythmias in ACHD.

Methods: A retrospective chart review was performed.

Success rates in pediatric WPW ablation are improved with 3-dimensional mapping systems compared with fluoroscopy alone: a multicenter study.

Introduction: Three-dimensional mapping (3-D) systems are frequently used for ablation of supraventricular tachycardia. Prior studies have demonstrated radiation dosage reduction with 3-D, but there are no data on whether 3-D improves the efficacy of ablation of Wolff-Parkinson-White syndrome (WPW). We sought to determine if 3-D improves the success rate for ablation of WPW in children.

Transesophageal echocardiography of intracardiac thrombus in congenital heart disease and atrial flutter: the importance of thorough examination of the Fontan.

Transesophageal echocardiography (TEE) is used in atrial flutter or fibrillation (AFF) before electric cardioversion to detect intracardiac thrombi. Previous studies have described the use of TEE to diagnose intracardiac thrombi in the left atrium and left atrial appendage, which has an incidence of 8 % among patients without congenital heart disease (CHD). In their practice the authors have noted a significant incidence of intracardiac thrombi in other structures of patients with CHD and AFF.

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.

Experience with CartoSound for arrhythmia ablation in pediatric and congenital heart disease patients.

Purpose: Electro-anatomic mapping (EAM) has been used for more than a decade to assist in defining arrhythmia propagation for transcatheter ablation. Intra-cardiac echocardiography (ICE) has also gained acceptance as an adjunct to further define intracardiac anatomy. The integration of these two technologies (CartoSound, Biosense-Webster, Diamond Bar, CA, USA) is a recent development.

Verapamil sensitive ventricular tachycardia associated with a cardiac hemangioma in the right ventricular outflow tract.

Primary tumors of the heart are rare, but they are often associated with refractory arrhythmias. Vascular tumors of the heart comprise a small minority of primary cardiac tumors. In patients with structurally normal hearts, ventricular tachycardia (VT) originating from the right ventricular outflow tract (RVOT) can be sensitive to adenosine, vagal maneuvers, and calcium channel blockers.