Pediatric nonpost-operative junctional ectopic tachycardia medical management and interventional therapies.

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.

Cardiac memory in patients with Wolff-Parkinson-White syndrome: noninvasive imaging of activation and repolarization before and after catheter ablation.

Background: Cardiac memory refers to a change in ventricular repolarization induced by and persisting for minutes to months after cessation of a period of altered ventricular activation (eg, resulting from pacing or preexcitation in patients with Wolff-Parkinson-White syndrome). ECG imaging (ECGI) is a novel imaging modality for noninvasive electroanatomic mapping of epicardial activation and repolarization.

Methods And Results: Fourteen pediatric patients with Wolff-Parkinson-White syndrome and no other congenital disease, were imaged with ECGI a day before and 45 minutes, 1 week, and 1 month after successful catheter ablation.

Markers of coronary sinus accessory pathways in pediatrics.

Introduction: Coronary sinus accessory pathways (CSAPs), atrioventricular connections formed by the coronary sinus myocardial coat, have been described in adult patients, but not systematically described in pediatric patients.

Methods: Patients who underwent CSAP ablation were compared to patients with right posteroseptal (RPS) pathway ablation (control group) from November 2004 to June 2007. Retrospective reviews of preablation 12-lead electrocardiogram (EKG), fluoroscopic, and intracardiac electrogram data were then performed to identify electrophysiologic markers of CSAP.

Hypertrophic cardiomyopathy with preexcitation: insights from noninvasive electrocardiographic imaging (ECGI) and catheter mapping.

Unlabelled: Hypertrophic Cardiomyopathy and Preexcitation.

Introduction: Fasciculoventricular pathway has been described as an unusual variant of preexcitation. Electrocardiographic imaging (ECGI) is a novel imaging modality for noninvasive electroanatomic mapping of epicardial activation and repolarization.

Experience and results during transition from radiofrequency ablation to cryoablation for treatment of pediatric atrioventricular nodal reentrant tachycardia.

Background: Cryoablation has emerged as a new, theoretically safer, modality for treating atrioventricular nodal reentrant tachycardia (AVNRT). The purpose of this study is to compare procedural aspects and outcomes during the transition from radiofrequency (RF) ablation to cryoablation for pediatric AVNRT.

Methods: Data were obtained retrospectively from 80 consecutive pediatric patients who underwent AVNRT ablation from 10/2001- 4/2006 (RF n = 42, Cryo n = 38).

Electrocardiographic diagnosis of myocardial ischemia in children: is a diagnostic electrocardiogram always diagnostic?

Electrocardiographic criteria for the diagnosis of cardiac ischemia in adults are well defined; however, analogous criteria for the diagnosis of cardiac ischemia in infants and children remain ambiguous. The difficulty in defining electrocardiographic criteria in pediatrics relates to age-dependent differences in the pediatric electrocardiogram, the presence or absence of congenital heart disease, and multiple and diverse etiologies of myocardial injury that lead to an ischemic pattern on the electrocardiogram. In this report, we illustrate 3 pediatric cases in which the electrocardiogram met adult diagnostic criteria for acute transmural myocardial infarction, without coronary artery abnormalities in 2 cases and with a transient coronary abnormality in the third.