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Boletín médico del Hospital Infantil de México
versión impresa ISSN 1665-1146
Resumen
VELAZQUEZ-RODRIGUEZ, Enrique et al. Coumel tachycardia in children. Bol. Med. Hosp. Infant. Mex. [online]. 2023, vol.80, suppl.1, pp.69-76. Epub 11-Sep-2023. ISSN 1665-1146. https://doi.org/10.24875/bmhim.22000127.
Background:
Coumel tachycardia is an infrequent form of supraventricular tachycardia (SVT) that usually occurs in infants and children. It is a tachycardia mediated by an accessory pathway with retrograde slow conduction that explains the classic ECG pattern with long RP' interval and negative P waves in leads II, III, and aVF. In this study, we describe the clinical course and management of Coumel tachycardia in children.
Case report:
We conducted a retrospective review of five consecutive pediatric patients, mean age 11 ± 3 years (range 6 to 14). The first episode of SVT was at a mean age of 10.4 ± 4.8 years (range 2 to 14) with a mean evolution of 7.4 ± 9.4 months (range 1 to 24). Pharmacological therapy was unsuccessful despite the combination of antiarrhythmic drugs. The tachycardia was incessant with a density > 85% by 24-hour Holter monitoring; one patient developed tachycardia-induced cardiomyopathy. All children underwent successful radiofrequency catheter ablation, mean 5 ± 3 applications (range 1 to 8) with a single session and with no complications. After a mean follow-up of 24 ± 16 months, all patients were asymptomatic and recurrence-free without antiarrhythmic treatment.
Conclusions:
Coumel tachycardia is clinically persistent and usually refractory to antiarrhythmic treatment with substantial risk of tachycardia-mediated cardiomyopathy. Catheter ablation is effective and safe in children; thus, it should be indicated promptly and based on individual selection.
Palabras llave : Coumel tachycardia; Permanent junctional reciprocating tachycardia; Supraventricular tachycardia; Tachycardia induced-cardiomyopathy; Catheter ablation in children.