Abstract

MALDONADO, SEBASTIÁN et al. Long-term Spontaneous Remission of Congenital Junctional Ectopic Tachycardia. Rev. argent. cardiol. [online]. 2018, vol.86, n.4, pp.5-9. ISSN 1850-3748.

Background: The congenital form of junctional ectopic tachycardia (JET) is a rare supraventricular tachycardia with high morbidity and mortality. Its treatment frequently requires the prolonged use of multiple drugs and, in some cases, an inva-sive procedure, such as cryoablation, is necessary. Some studies have demonstrated the existence of spontaneous remission of arrhythmia in the long term (with reversal to sinus rhythm or to an accelerated nodal rhythm), without need of drugs or any other form of intervention.

Objectives: The aim of this study was to evaluate the long-term incidence of spontaneous remission of congenital JET in a pediatric population.

Methods: Twenty-three consecutive patients with congenital JET were evaluated at Hospital J.P. Garrahan and Hospital Italiano de Buenos Aires, between 1999 and 2017, with a mean follow-up of 8.8 years interquartile range (IQR): 5.5-14.1). The incidence of spontaneous arrhythmia remission was evaluated in the long term.

Results: Median presentation age was 2 months (IQR: 0.625-3); 15 patients (62.5%) presented signs of heart failure and 11 patients (45.8%) tachycardiomyopathy. Two patients underwent successful cryoablation. The spontaneous remission rate was 52%. In patients with follow-up above 10 years (15 subjects), remission was 62.5%. Mean remission age was 9.6 years. Conclusions: Congenital JET is a potentially severe tachycardia in the first months of life, but with a high rate of long-term spontaneous remission.

Keywords : Tachycardia; Ectopic Junctional/congenital - Tachycardia; Supraventricular - Remission; Spontaneous.

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