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PERSPECTIVE
Year : 2001  |  Volume : 2  |  Issue : 1  |  Page : 6-15

Treatment strategies of supraventricular tachycardia and asymptomatic wolff-parkinsonwhite syndrome in children


Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taiwan, and University of Miami, Florida, U.S.A

Correspondence Address:
Ming-Lon Young
Ming-Lon Young, M.D., Department of Pediatrics, (R-76), University of Miami, P.O. Box 016960, Miami, FL 33101
U.S.A
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Source of Support: None, Conflict of Interest: None


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Supraventricular tachycardia (SVT) is a common arrhythmia in children. Acute conversion of the SVT begins with documentation of the arrhythmia. In life-threatening situations direct current (DC) cardioversion is mandatory. Before DC cardioversion, vagal maneuvers may be performed. Adenosine is the first-line drug for acute pharmacological conversion. For patients with chronic SVT there are 3 approaches: “no treatment”, antiarrhythmic drug therapy, or radiofrequency catheter ablation. From 1995 to 2000, a total of 343 children and adolescents underwent 329 radiofrequency (RF) catheter ablation procedures in the University of Miami. The success rate for all accessory pathways was 93%; for atrioventricular nodal reentrant tachycardia: 98%; for atrial flutter: 88%; for ectopic atrial tachycardia: 82%; and for junctional ectopic tachycardia: 63%. The overall recurrence rate at a follow up period of 29±23 months was 2.6 %. The procedure time was 235±109 min and the fluoroscopy time was 43±39 min. Our ablation-related complication rate was 2%. We designed several treatment algorithms according to disease categories, severity of symptoms, effects of drug therapy, weight of the patients, and the accessory pathway location and conduction characteristics. By fully utilizing all currently available treatment options it is hoped that these algorithms can be stailored to the needs of each patient.


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