Moderate hypothermia in the management of resistant automatic tachycardias in children

S. Balaji, I. Sullivan, J. Deanfield, I. James

Research output: Contribution to journalArticle

63 Scopus citations

Abstract

Background - Automatic focus tachycardias are often resistant to electrical and pharmacological treatment. Moderate systemic hypothermia (32-34°C) may reduce the tachycardia rate in children with His bundle tachycardia after cardiac surgery. Methods - The case notes of seven children with automatic focus tachycardias treated with hypothermia were reviewed. Six had His bundle tachycardia after cardiac surgery and one had ectopic atrial tachycardia; all had signs of low cardiac output. Results - Hypothermia led to a reduction in heart rate in all patients (from 211 (28) (mean (SD)) to 146 (5) beats/ minute, p < 0.001), with rises in systolic blood pressure (from 74 (14) mm Hg to 97 (10) mm Hg, p < 0.01) and hourly urine output (from 0.5 (0.4) ml/kg to 4,6 (2.8) ml/kg, p < 0.02). No direct adverse effects were noted. The arrhythmia did not resolve in three children, who died (two with His bundle tachycardia after Fontan procedures and one with ectopic atrial tachycardia); the other four regained sinus rhythm which was maintained at follow up of 3-13 (mean 9) months. Conclusions - Moderate systemic hypothermia led to slowing of the arrhythmia rate and an improvement in cardiac output in patients with resistant automatic focus tachycardias. It can be used to improve the haemodynamic condition while other measures of arrhythmia control are being pursued or until spontaneous recovery of normal rhythm.

Original languageEnglish (US)
Pages (from-to)221-224
Number of pages4
JournalBritish Heart Journal
Volume66
Issue number3
StatePublished - Jan 1 1991

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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