Coumel tachycardia in children
Background: Coumel tachycardia is an infrequent form of supraventricular tachycardia (SVT) that usually occurs in infants and children. It is a tachycardia mediated by an accessory pathway with retrograde slow conduction that explains the classic ECG pattern with long RP’ interval and negative P wav...
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Permanyer
2023-01-01
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| Series: | Boletín Médico del Hospital Infantil de México |
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| Online Access: | https://www.bmhim.com/frame_esp.php?id=383 |
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| author | Enrique Velázquez-Rodríguez Norberto García-Hernández Arturo Martínez-Sánchez Carlos Alva-Espinoza Lucelli Yáñez-Gutiérrez Santiago Jiménez-Arteaga |
| author_facet | Enrique Velázquez-Rodríguez Norberto García-Hernández Arturo Martínez-Sánchez Carlos Alva-Espinoza Lucelli Yáñez-Gutiérrez Santiago Jiménez-Arteaga |
| author_sort | Enrique Velázquez-Rodríguez |
| collection | DOAJ |
| description | Background: Coumel tachycardia is an infrequent form of supraventricular tachycardia (SVT) that usually occurs in infants and children. It is a tachycardia mediated by an accessory pathway with retrograde slow conduction that explains the classic ECG pattern with long RP’ interval and negative P waves in leads II, III, and aVF. In this study, we describe the clinical course and management of Coumel tachycardia in children. Case report: We conducted a retrospective review of five consecutive pediatric patients, mean age 11 ± 3 years (range 6 to 14). The first episode of SVT was at a mean age of 10.4 ± 4.8 years (range 2 to 14) with a mean evolution of 7.4 ± 9.4 months (range 1 to 24). Pharmacological therapy was unsuccessful despite the combination of antiarrhythmic drugs. The tachycardia was incessant with a density > 85% by 24-hour Holter monitoring; one patient developed tachycardia-induced cardiomyopathy. All children underwent successful radiofrequency catheter ablation, mean 5 ± 3 applications (range 1 to 8) with a single session and with no complications. After a mean follow-up of 24 ± 16 months, all patients were asymptomatic and recurrence-free without antiarrhythmic treatment. Conclusions: Coumel tachycardia is clinically persistent and usually refractory to antiarrhythmic treatment with substantial risk of tachycardia-mediated cardiomyopathy. Catheter ablation is effective and safe in children; thus, it should be indicated promptly and based on individual selection.
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| first_indexed | 2024-03-12T21:54:38Z |
| format | Article |
| id | doaj.art-ee3dbf315363471cb7b7ed510d46aff1 |
| institution | Directory Open Access Journal |
| issn | 0539-6115 |
| language | English |
| last_indexed | 2024-03-12T21:54:38Z |
| publishDate | 2023-01-01 |
| publisher | Permanyer |
| record_format | Article |
| series | Boletín Médico del Hospital Infantil de México |
| spelling | doaj.art-ee3dbf315363471cb7b7ed510d46aff12023-07-25T20:20:06ZengPermanyerBoletín Médico del Hospital Infantil de México0539-61152023-01-01809110.24875/BMHIM.22000127Coumel tachycardia in childrenEnrique Velázquez-Rodríguez0Norberto García-Hernández1Arturo Martínez-Sánchez2Carlos Alva-Espinoza3Lucelli Yáñez-Gutiérrez4Santiago Jiménez-Arteaga5Servicio de Electrofisiología, Unidad Médica de Alta Especialidad Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, MexicoServicio de Electrofisiología, Unidad Médica de Alta Especialidad Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, MexicoServicio de Cardiopatías Congénitas, Unidad Médica de Alta Especialidad Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social; Universidad Nacional Autónoma de México. Mexico City, MexicoServicio de Cardiopatías Congénitas, Unidad Médica de Alta Especialidad Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social; Universidad Nacional Autónoma de México. Mexico City, MexicoServicio de Cardiopatías Congénitas, Unidad Médica de Alta Especialidad Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social; Universidad Nacional Autónoma de México. Mexico City, MexicoServicio de Cardiopatías Congénitas, Unidad Médica de Alta Especialidad Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social; Universidad Nacional Autónoma de México. Mexico City, MexicoBackground: Coumel tachycardia is an infrequent form of supraventricular tachycardia (SVT) that usually occurs in infants and children. It is a tachycardia mediated by an accessory pathway with retrograde slow conduction that explains the classic ECG pattern with long RP’ interval and negative P waves in leads II, III, and aVF. In this study, we describe the clinical course and management of Coumel tachycardia in children. Case report: We conducted a retrospective review of five consecutive pediatric patients, mean age 11 ± 3 years (range 6 to 14). The first episode of SVT was at a mean age of 10.4 ± 4.8 years (range 2 to 14) with a mean evolution of 7.4 ± 9.4 months (range 1 to 24). Pharmacological therapy was unsuccessful despite the combination of antiarrhythmic drugs. The tachycardia was incessant with a density > 85% by 24-hour Holter monitoring; one patient developed tachycardia-induced cardiomyopathy. All children underwent successful radiofrequency catheter ablation, mean 5 ± 3 applications (range 1 to 8) with a single session and with no complications. After a mean follow-up of 24 ± 16 months, all patients were asymptomatic and recurrence-free without antiarrhythmic treatment. Conclusions: Coumel tachycardia is clinically persistent and usually refractory to antiarrhythmic treatment with substantial risk of tachycardia-mediated cardiomyopathy. Catheter ablation is effective and safe in children; thus, it should be indicated promptly and based on individual selection. https://www.bmhim.com/frame_esp.php?id=383Coumel tachycardia. Permanent junctional reciprocating tachycardia. Supraventricular tachycardia. Tachycardia induced-cardiomyopathy. Catheter ablation in children. |
| spellingShingle | Enrique Velázquez-Rodríguez Norberto García-Hernández Arturo Martínez-Sánchez Carlos Alva-Espinoza Lucelli Yáñez-Gutiérrez Santiago Jiménez-Arteaga Coumel tachycardia in children Boletín Médico del Hospital Infantil de México Coumel tachycardia. Permanent junctional reciprocating tachycardia. Supraventricular tachycardia. Tachycardia induced-cardiomyopathy. Catheter ablation in children. |
| title | Coumel tachycardia in children |
| title_full | Coumel tachycardia in children |
| title_fullStr | Coumel tachycardia in children |
| title_full_unstemmed | Coumel tachycardia in children |
| title_short | Coumel tachycardia in children |
| title_sort | coumel tachycardia in children |
| topic | Coumel tachycardia. Permanent junctional reciprocating tachycardia. Supraventricular tachycardia. Tachycardia induced-cardiomyopathy. Catheter ablation in children. |
| url | https://www.bmhim.com/frame_esp.php?id=383 |
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