Multifokal atriyal taşikardi: Bir olgu

Multifokal atriyal taşikardi, çocuklarda nadir görülen, en az 3 farklı ektopik odaktan kaynaklanan P dalgaları ile en az 3 veya daha fazla farklı ektopik P-P siklusu ile karakterize bir atriyal taşiaritmidir. Genellikle 1 yaşından küçük ve sağlıklı infantlarda görülür. İnfantlarda prognoz, erişkinlere göre daha iyidir. Uzun süren taşikardiye veya miyokardite bağlı dilate kardiyomiyopati gelişmişse, prognoz kötü olabilir. Bu çalışmada kalp yetmezliği bulguları ile başvuran, dilate kardiyomiyopati tespit edilen, tedaviye rağmen yatışından 7 saat sonra kaybedilen 3 aylık multifokal atriyal taşikardi olgusu sunuyoruz.

Anahtar Kelimeler:

Taşikardi, ektopik atriyal, Süt çocuğu, Erkek, Taşikardi, Ölümle sonuçlanma, Ekokardiyografi, Kardiyomiyopati, dilate, Tedavi başarısızlığı

Multifocal atrial tachycardia: A case report

In children, multifocal atrial tachycardia is an uncommon atrial tachyarrhythmia, which is characterized by three or more ectopic P waves with three or more different ectopic P-P cycles. This arrhythmia occurs most often in infants younger than 1 year with otherwise healthy children. In infants with multifocal atrial tachycardia, prognosis is better than adults. If the dilated cardiomyopathy develops secondary to chronic tachycardia or myocarditis, the prognosis may be poor. We presented a 3-month infant, who was brought to the hospital with findings of congestive heart failure and diagnosed as having dilateted cardiomyopaty, and dead 7 hours after admission despite therapy.

Keywords:

Tachycardia, Ectopic Atrial, Infant, Male, Tachycardia, Fatal Outcome, Echocardiography, Cardiomyopathy, Dilated, Treatment Failure,

PDF

___

1. McCord J, Borzak S. Multifocal atrial tachycardia. Chest 1998;113:203-9.
2. Bradley DJ, Fischbach PS, Law IH, Serwer GA, Dick M. The clinical course of multifocal atrial tachycardia in infants and children.J Am Coll Cardiol 2001;38: 401-8.
3. Hsieh MY, Lee PC, Hwang B, Meng CC. Multifocal atrial tachycardia in 2 children. J Chin Med Assoc 2006;69: 439-43.
4. Southall DP, Johnson AM, Shinebourne EA, Johnston PG, Vulliamy DG. Frequency and outcome of disorders of cardiac rhythm and conduction in a population of newborn infants. Pediatrics 1981;68: 58-66.
5. Shine KI, Kastor JA, Yurchak PM. Multifocal atrial tachycardia. Clinical and electrocardiographic features in 32 patients. N Engl J Med 1968;279: 344-9
6. Gouin S, Ali S. A patient with chaotic atrial tachycardia. Pediatr Emerg Care 2003;19: 95-8.
7. Wu MY, Wu ZF, Chen XY.Chaotic atrial tachycardia in 22 infants. Chin Med J (Engl) 1984;97:500-3.
8. Bisset GS III, Seigel SF, Gaum WE, Kaplan S. Chaotic atrial tachycardia in childhood. Am Heart J 1981;101: 268-72.
9. Calò L, De Ruvo E, Sette A, Sciarra L, Scioli R, Sebastiani F, et al. Tachycardia-induced cardiomyopathy: mechanisms of heart failure and clinical implications. J Cardiovasc Med (Hagerstown) 2007;8: 138-43.
10. Kannankeril PJ, Fish FA. Disorders of cardiac rhythm and conduction. In: Allen HD, Driscoll DJ, Shaddy RE, Feltes TF, editors. 7th ed, Heart Disease in Infants, Children, and Adolescents. Philadelphia: Lipincott Williams & Wilkins, a Wolters Kluwer p.293-342.
11. Farooki ZQ, Green EW. Multifocal atrial tachycardia in two neonates. Br Heart J 1977;39: 872-4
12. Tipple M, Sandor G.Efficacy and safety of oral sotalol in early infancy. Pacing Clin Electrophysiol 1991;14: 2062-5.
13. Strasburger JF, Smith RT Jr, Moak JP, Gothing C, Garson A Jr. Encainide for resistant supraventricular tachycardia in children: follow-up report. Am J Cardiol 1988 20;62: 50-4.
14. Houyel L, Fournier A, Davignon A. Successful treatment of chaotic atrial tachycardia with oral flecainide. Int J Cardiol 1990;27: 27-9.
15. Zeevi B, Berant M, Sclarovsky S, Blieden LC. Treatment of multifocal atrial tachycardia with amiodarone in a child with congenital heart disease. Am J Cardiol 1986;57: 344-5.
16. Salim MA, Case CL, Gilette PC. Chaotic atrial tachycardia in children. Am Heart J 1995;129: 990-5.
17. Liberthson RR, Colan SD. Multifocal or chaotic atrial rhythm: report of nine infants, delineation of clinical course and management, and review of the literature. Pediatr Cardiol 1982;2: 179-84.