CLINICAL SECTION   

Medicina dello Sport 1999 September;52(3):177-81

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: Italian

Chronic supraventricular tachycardias

Barone A., Zavota L., Agnetti A., Carano N., Squarcia M., Squarcia U.

Clinica Pediatrica, Centro Malattie Cardiovascolari, Università degli Studi - Parma

Chronic supraventricular tachycardias are quite uncommon arrhythmias, predominately pediatric. They can be incessant or repetitive. They are the permanent junctional reciprocating tachycardia (PJRT), the atrial ectopic tachycardia (AET) and the junctional ectopic tachycardia (JET). The PJRT is a type of orthodromic atrioventricular re-entry, while the AET and the JET are automatic arrhythmias. Clinical features depend on the arrhythmia duration in time, on its frequency per day, and on heart rate during tachycardia.
Such arrhythmias are chronic and can resolve spontaneously. They are usually diagnosed during infancy or childhood, after accidental observation of an excessively high heart rate, or may present through symptoms (palpitations, chest pain etc.) or through signs and symptoms of heart failure secondary to left ventricular dysfunction. A few cases may present in utero. These arrhythmias are difficult to treat. In most cases the best that can be achieved is rate control rather than arrhythmia suppression. Rate control is likely to prevent ventricular dysfunction. Drug treatment with class Ic or class III drugs is most likely to be effective. Radiofrequency ablation is an effective and safe procedure in selected patients.