Collins Kathryn K, Van Hare George F, Kertesz Naomi J, Law Ian H, Bar-Cohen Yaniv, Dubin Anne M, Etheridge Susan P, Berul Charles I, Avari Jennifer N, Tuzcu Volkan, Sreeram Narayanswami, Schaffer Michael S, Fournier Anne, Sanatani Shubhayan, Snyder Christopher S, Smith Richard T, Arabia Luis, Hamilton Robert, Chun Terrence, Liberman Leonardo, Kakavand Bahram, Paul Thomas, Tanel Ronn E
Department of Pediatrics, Division of Cardiology, The Children's Hospital, 13123 E. 16th Avenue, Aurora, CO 80045, USA.
J Am Coll Cardiol. 2009 Feb 24;53(8):690-7. doi: 10.1016/j.jacc.2008.11.019.
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.
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.
This is an international, multicenter retrospective outcome study of pediatric patients treated for nonpost-operative JET.
A total of 94 patients with JET and 5 patients with accelerated junctional rhythm (age 0.8 year, range fetus to 16 years) from 22 institutions were identified. JET patients presenting at age < or =6 months were more likely to have incessant JET and to have faster JET rates. Antiarrhythmic medications were utilized in a majority of JET patients (89%), and of those, amiodarone was the most commonly reported effective agent (60%). Radiofrequency ablation was conducted in 17 patients and cryoablation in 27, with comparable success rates (82% radiofrequency vs. 85% cryoablation, p = 1.0). Atrioventricular junction ablation was required in 3% and pacemaker implantation in 14%. There were 4 (4%) deaths, all in patients presenting at age < or =6 months.
Patients with nonpost-operative JET have a wide range of clinical presentations, with younger patients demonstrating higher morbidity and mortality. With current medical, ablative, and device therapies, the majority of patients have a good clinical outcome.
确定药物治疗、起搏治疗和导管消融治疗小儿非术后交界性异位性心动过速（JET）的疗效。
非术后JET是一种罕见的快速心律失常，其发病率和死亡率较高。大多数临床疗效报告发表于胺碘酮或消融治疗常规应用之前。
这是一项针对小儿非术后JET治疗的国际多中心回顾性疗效研究。
共确定了来自22家机构的94例JET患者和5例交界性心律加速患者（年龄0.8岁，范围从胎儿至16岁）。年龄≤6个月的JET患者更易发生持续性JET且JET心率更快。大多数JET患者（89%）使用了抗心律失常药物，其中，胺碘酮是最常报告的有效药物（60%）。17例患者接受了射频消融，27例接受了冷冻消融，成功率相当（射频消融82% vs.冷冻消融85%，p = 1.0）。3%的患者需要进行房室交界区消融，14%的患者需要植入起搏器。有4例（4%）死亡，均为年龄≤6个月的患者。
非术后JET患者临床表现多样，年龄较小的患者发病率和死亡率更高。采用目前的药物、消融和器械治疗，大多数患者临床疗效良好。
