title: Pediatric nonpost-operative junctional ectopic tachycardia medical management and interventional therapies.
abstract: OBJECTIVE
  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.
  
  
  BACKGROUND
  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.
  
  
  METHODS
  This is an international, multicenter retrospective outcome study of pediatric patients treated for nonpost-operative JET.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Division of Cardiology, The Children's Hospital, 13123 E. 16th Avenue, Aurora, CO 80045, USA. Collins.kathryn@tchden.org
authors.forename: Kathryn K
authors.initials: KK
authors.lastname: Collins
authors.forename: George F
authors.initials: GF
authors.lastname: Van Hare
authors.forename: Naomi J
authors.initials: NJ
authors.lastname: Kertesz
authors.forename: Ian H
authors.initials: IH
authors.lastname: Law
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Bar-Cohen
authors.forename: Anne M
authors.initials: AM
authors.lastname: Dubin
authors.forename: Susan P
authors.initials: SP
authors.lastname: Etheridge
authors.forename: Charles I
authors.initials: CI
authors.lastname: Berul
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Avari
authors.forename: Volkan
authors.initials: V
authors.lastname: Tuzcu
authors.forename: Narayanswami
authors.initials: N
authors.lastname: Sreeram
authors.forename: Michael S
authors.initials: MS
authors.lastname: Schaffer
authors.forename: Anne
authors.initials: A
authors.lastname: Fournier
authors.forename: Shubhayan
authors.initials: S
authors.lastname: Sanatani
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Snyder
authors.forename: Richard T
authors.initials: RT
authors.lastname: Smith
authors.forename: Luis
authors.initials: L
authors.lastname: Arabia
authors.forename: Robert
authors.initials: R
authors.lastname: Hamilton
authors.forename: Terrence
authors.initials: T
authors.lastname: Chun
authors.forename: Leonardo
authors.initials: L
authors.lastname: Liberman
authors.forename: Bahram
authors.initials: B
authors.lastname: Kakavand
authors.forename: Thomas
authors.initials: T
authors.lastname: Paul
authors.forename: Ronn E
authors.initials: RE
authors.lastname: Tanel
mesh_terms: D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D017115:Catheter Ablation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010138:Pacemaker, Artificial; D013613:Tachycardia, Ectopic Junctional / Q000628:therapy*
chemical_list: D000889:Anti-Arrhythmia Agents