Pharmacological and non-pharmacological therapy for arrhythmias in the pediatric population: EHRA and AEPC-Arrhythmia Working Group joint consensus statement

Brugada, Josep; Blom, Nico; Sarquella-Brugada, Georgia; Blomstrom-Lundqvist, Carina; Deanfield, John; Janousek, Jan; Abrams, Dominic; Bauersfeld, Urs; Brugada, Ramon; Drago, Fabrizio; de Groot, Natasja; Happonen, Juha-Matti; Hebe, Joachim; Yen Ho, Siew; Marijon, Eloi; Paul, Thomas; Pfammatter, Jean-Pierre; Rosenthal, Eric (2013). Pharmacological and non-pharmacological therapy for arrhythmias in the pediatric population: EHRA and AEPC-Arrhythmia Working Group joint consensus statement. Europace, 15(9), pp. 1337-1382. Oxford University Press 10.1093/europace/eut082

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In children with structurally normal hearts, the mechanisms of arrhythmias are usually the same as in the adult patient. Some arrhythmias are particularly associated with young age and very rarely seen in adult patients. Arrhythmias in structural heart disease may be associated either with the underlying abnormality or result from surgical intervention. Chronic haemodynamic stress of congenital heart disease (CHD) might create an electrophysiological and anatomic substrate highly favourable for re-entrant arrhythmias. As a general rule, prescription of antiarrhythmic drugs requires a clear diagnosis with electrocardiographic documentation of a given arrhythmia. Risk-benefit analysis of drug therapy should be considered when facing an arrhythmia in a child. Prophylactic antiarrhythmic drug therapy is given only to protect the child from recurrent supraventricular tachycardia during this time span until the disease will eventually cease spontaneously. In the last decades, radiofrequency catheter ablation is progressively used as curative therapy for tachyarrhythmias in children and patients with or without CHD. Even in young children, procedures can be performed with high success rates and low complication rates as shown by several retrospective and prospective paediatric multi-centre studies. Three-dimensional mapping and non-fluoroscopic navigation techniques and enhanced catheter technology have further improved safety and efficacy even in CHD patients with complex arrhythmias. During last decades, cardiac devices (pacemakers and implantable cardiac defibrillator) have developed rapidly. The pacing generator size has diminished and the pacing leads have become progressively thinner. These developments have made application of cardiac pacing in children easier although no dedicated paediatric pacing systems exist.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Pfammatter, Jean-Pierre

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1099-5129

Publisher:

Oxford University Press

Language:

English

Submitter:

André Schaller

Date Deposited:

10 Apr 2014 15:19

Last Modified:

10 Apr 2014 15:21

Publisher DOI:

10.1093/europace/eut082

PubMed ID:

23851511

Uncontrolled Keywords:

Antiarrhythmic drugs, Arrhythmias, Electrical devices, Paediatrics, Radiofrequency ablation

URI:

https://boris.unibe.ch/id/eprint/50245

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