Institutional experience of healthy pediatric patients presenting with atrial fibrillation who had an electrophysiology study
- 12 March 2020
- journal article
- research article
- Published by Hindawi Limited in Journal of Cardiac Surgery
- Vol. 35 (5), 1004-1009
- https://doi.org/10.1111/jocs.14506
Abstract
Introduction Atrial fibrillation (AF) is a very common tachyarrhythmia with increasing prevalence with age, but uncommon in the pediatric population. Understanding that AF increases comorbidities make the need for investigation and potential elimination of alternate etiologies in pediatric AF patients critical. The objective of this study was to review our institutional data and compare our findings with previously documented adult AF risk factors to pediatric patients while also identifying which patients had alternate electrophysiology diagnoses amenable to transcatheter ablation. Methods A retrospective chart review was performed identifying AF patients who were less than 21 years old, had no significant congenital cardiovascular anomalies, a documented episode of AF on electrocardiogram and underwent invasive electrophysiology study (EPS). Results Nineteen patients were identified over a 9‐year period of time finding a male predominance (74%), the average age of 14.95 ± 4.17 years, the average weight of 78.5 ± 31.4 kg, and average body mass index of 26.8 ± 6.87 kg/m2. Preprocedural left atrial volumes made on echocardiograms demonstrated a mean of 33.96 ± 16.35 mL/m2 (Z‐scores −0.81 ± 1.50), indicating no dilation. Five of nineteen patients (26%) had additional electrophysiologic diagnoses during EPS, including atrioventricular reentrant tachycardia (n = 2, 10%) and atrioventricular nodal reentrant tachycardia (n = 3, 16%). Four patients underwent successful ablation with no documented or clinical AF recurrence. Conclusions Adult risk factors of male predominance and obesity were seen in pediatric AF patients, while left atrial enlargement was not. Twenty‐one percent of the pediatric AF patients who had additional electrophysiologic substrates and successful ablations resulted in no further clinical episodes of AF. This suggests that pediatric patients presenting with AF might benefit from an EPS as part of a complete evaluation.Keywords
This publication has 18 references indexed in Scilit:
- Lone Pediatric Atrial Fibrillation in the United States: Analysis of Over 1500 CasesPediatric Cardiology, 2017
- Atrial fibrillation: prevalence in a large database of primary care patients in BrazilEP Europace, 2015
- Dementia in subjects with atrial fibrillation: hemostatic function and the role of anticoagulationJournal of Thrombosis and Haemostasis, 2004
- Prothrombotic Activity Is Increased in Patients With Nonvalvular Atrial Fibrillation and Risk Factors for EmbolismSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2004
- The Different Electrophysiological Characteristics in Children with Wolff‐Parkinson‐White Syndrome Between Those with and Without Atrial FibrillationPacing and Clinical Electrophysiology, 2004
- Atrial Fibrillation after Cardiac SurgeryAnnals of Internal Medicine, 2001
- Prevalence of Diagnosed Atrial Fibrillation in AdultsJAMA, 2001
- Prevalence, Age Distribution, and Gender of Patients With Atrial FibrillationArchives of Internal Medicine, 1995
- Atrial fibrillation as an independent risk factor for stroke: the Framingham Study.Stroke, 1991
- Relation of syncope in young patients with Wolff-Parkinson-White syndrome to rapid ventricular response during atrial fibrillationThe American Journal of Cardiology, 1990