title: Lone atrial fibrillation in the young - perhaps not so "lone"?
abstract: OBJECTIVE
  To determine if pediatric patients with a history of lone atrial fibrillation (AF) have other forms of supraventricular tachycardia (SVT) that may potentially trigger AF.
  
  
  METHODS
  A multicenter review of patients with lone AF who underwent electrophysiology (EP) study from 2006-2011 was performed.
  
  
  METHODS
  age ≤21 years, normal ventricular function, structurally normal heart, history of AF, and EP study and/or ablation performed.
  
  
  METHODS
  congenital heart disease or cardiomyopathy. Patient demographics, findings at EP study and follow-up data were recorded.
  
  
  RESULTS
  Eighteen patients met inclusion criteria. The mean age was 17.9 ± 2.2 years, weight was 82 ± 21 kg, body mass index was 27 ± 6, and 15 (83%) were males. Eleven (61%) were overweight or obese. Seven (39%) had inducible SVT during EP study: 5 atrioventricular nodal re-entry tachycardia (71%) and 2 concealed accessory pathways with inducible atrioventricular re-entry tachycardia (29%). All 7 patients with inducible SVT underwent radiofrequency ablation. There were no complications during EP study and/or ablation for all 18 patients. The mean follow-up was 1.7 ± 1.5 years and there were no recurrences in the 7 patients who underwent ablation. There were 2 recurrences of AF in patients with no other form of SVT during EP study.
  
  
  CONCLUSIONS
  Inducible SVT was found in 39% of pediatric patients undergoing EP study for lone AF. EP study should be considered for pediatric patients presenting with lone AF.
authors.affiliation: Pediatric Arrhythmia Service, Division of Pediatric Cardiology, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY 10467-2490, USA. ceresnak@yahoo.com
authors.forename: Scott R
authors.initials: SR
authors.lastname: Ceresnak
authors.forename: Leonardo
authors.initials: L
authors.lastname: Liberman
authors.forename: Eric S
authors.initials: ES
authors.lastname: Silver
authors.forename: Steven B
authors.initials: SB
authors.lastname: Fishberger
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Gates
authors.forename: Lynn
authors.initials: L
authors.lastname: Nappo
authors.forename: Joseph
authors.initials: J
authors.lastname: Mahgerefteh
authors.forename: Robert H
authors.initials: RH
authors.lastname: Pass
mesh_terms: D000293:Adolescent; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis*; D002309:Cardiology / Q000379:methods; D002648:Child; D015331:Cohort Studies; D004562:Electrocardiography / Q000379:methods; D004594:Electrophysiology / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D010372:Pediatrics / Q000379:methods; D012189:Retrospective Studies; D013617:Tachycardia, Supraventricular / Q000150:complications / Q000175:diagnosis*; D016896:Treatment Outcome