Benjamín Mónica N, Infante Juan, Olmedo Julián, Abello Mauricio, Moltedo José M
Servicio de Cardiología Pediátrica, Hospital de Niños de Córdoba, Buenos Aires, Argentina.
Medicina (B Aires). 2011;71(6):521-4.
Congenital junctional ectopic tachycardia (JET) is a rare arrhythmia that can be refractory to medical therapy with high morbidity and mortality rates. The aim of this study was to report our experience with pharmacologic management of congenital JET in infants. Seven patients with congenital JET were identified between 2008 and 2010. Only two of them presented dilated cardiomyopathy. There were no congenital structural defects. Amiodarone was given to all the patients, as single therapy in one, and in combination with propranolol in four. In one patient flecainide was administered together with amiodarone and propranolol, and in another patient was used combined with amiodarone. During follow- up with an average time of 12.2 months (median 9.75 months, range 1-28 months), sinus rhythm alternating with slow junctional tachycardia was successfully achieved in 3 patients; no side effects were detected. There was only one death in our study group. The combination of different antiarrhythmics (amiodarone plus propranolol, and eventually flecainide) is a valid option for rhythm control and management of JET in infants.
先天性交界性异位性心动过速(JET)是一种罕见的心律失常,药物治疗往往无效,且发病率和死亡率很高。本研究旨在报告我们对婴儿先天性JET进行药物治疗的经验。2008年至2010年间共确诊7例先天性JET患者。其中只有2例出现扩张型心肌病。无先天性结构缺陷。所有患者均接受了胺碘酮治疗,1例单独使用,4例与普萘洛尔联合使用。1例患者同时接受氟卡尼与胺碘酮和普萘洛尔治疗,另1例患者接受氟卡尼与胺碘酮联合治疗。在平均12.2个月(中位数9.75个月,范围1 - 28个月)的随访期间,3例患者成功实现窦性心律与缓慢交界性心动过速交替,未发现副作用。我们的研究组仅1例死亡。不同抗心律失常药物(胺碘酮加普萘洛尔,最终加用氟卡尼)联合使用是控制婴儿JET节律和进行治疗的有效选择。