TY - JOUR
T1 - Moderate hypothermia in the management of resistant automatic tachycardias in children
AU - Balaji, S.
AU - Sullivan, I.
AU - Deanfield, J.
AU - James, I.
PY - 1991
Y1 - 1991
N2 - 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.
AB - 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.
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U2 - 10.1136/hrt.66.3.221
DO - 10.1136/hrt.66.3.221
M3 - Article
C2 - 1931349
AN - SCOPUS:0025910273
SN - 0007-0769
VL - 66
SP - 221
EP - 224
JO - British Heart Journal
JF - British Heart Journal
IS - 3
ER -