Atrioventricular Reentry Tachycardia
Supraventricular tachycardia (SVT) is the most common tachyarrhythmia in children, occurring in as many as 1–3 in 2,000 children. Of these, 90 % involve a reentrant circuit (Chap. 3) including atrioventricular (AV) reentrant tachycardia (AVRT), AV node reentrant tachycardia (AVNRT, Chap. 5), or persistent junctional reciprocal tachycardia (Chap. 6). The majority (50–60 %) of reentrant SVT presents in the first year of life, but may exhibit spontaneous resolution. When documented SVT is occurs in infants younger than 6 months of age 15–40 % will not have a recurrence of SVT beyond their first year of life. As children age the relative proportion of those with AV reentrant tachycardia diminishes from 85 % in children less than 1 year to 82 % in children between 1 and 5 years and 56 % between 6 and 10 years of age. As children pass into the adolescent years, AVNRT becomes slightly more common than AVRT. Finally, AVRT is more common in males.
KeywordsSupraventricular Tachycardia Accessory pathways Antidromic tachycardia Atrioventricular fibers Concealed pathways Mahaim fibers Manifest pathways Orthodromic tachycardia Reentry Supraventricular Tachycardia Transcatheter ablation of atrioventricular tachycardia Vagal maneuvers Wolff–Parkinson–White syndrome
- Chiang CE, Chen SA, Teo WS, et al. An accurate stepwise electrocardiographic algorithm for localization of accessory pathways in patients with Wolff-Parkinson-White syndrome from a comprehensive analysis of delta waves and R/S ratio during sinus rhythm. Am J Cardiol. 1995;76:40–6.CrossRefPubMedGoogle Scholar
- Kugler JD, Danford DA, Houston K, Felix G. Radiofrequency catheter ablation for paroxysmal supraventricular tachycardia in children and adolescents without structural heart disease. Pediatric EP Society, Radiofrequency Catheter Ablation Registry. Am J Cardiol. 1997;80:1438–43.CrossRefPubMedGoogle Scholar
- O’Connor BK, Dick M. What every pediatrician should know about supraventricular tachycardia. Pediatr Ann. 1991;20(368):371–6.Google Scholar
- Pappone C, Santinelli V, Rosanio S, Vicedomini G, et al. Usefulness of invasive electrophysiologic testing to stratify the risk of arrhythmic events in asymptomatic patients with Wolff-Parkinson-White pattern: results from a large prospective long-term follow-up study. J Am Coll Cardiol. 2003b;41:239–44.CrossRefPubMedGoogle Scholar
- Pediatric and Congenital Electrophysiology Society (PACES), Heart Rhythm Society (HRS), American College of Cardiology Foundation (ACCF), American Heart Association (AHA), American Academy of Pediatrics (AAP), Canadian Heart Rhythm Society (CHRS), Cohen MI, Triedman JK, Cannon BC, Davis AM, et al. PACES/HRS expert consensus statement on the management of the asymptomatic young patient with a Wolff-Parkinson-White (WPW, ventricular preexcitation) electrocardiographic pattern: Heart Rhythm. 2012;9(6):1006–24.Google Scholar