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Ivabradine is an effective antiarrhythmic therapy for congenital junctional ectopic tachycardia-induced cardiomyopathy during infancy: Case studies.
Pacing Clin Electrophysiol 2018; 41(10):1372-1377PC

Abstract

Junctional ectopic tachycardia (JET) is a rare form of arrhythmia that is most commonly seen during infancy. JET is continuous and incessant, characterized by persistently high heart rates that may result in impaired cardiac function and tachycardia-induced cardiomyopathy. Despite the availability of multiple antiarrhythmic treatments, including flecainide and amiodarone, management of JET is generally very difficult. Catheter ablation has a high risk of atrioventricular block and it may require the placement of a pacemaker. Ivabradine, also known as a cardiac pacemaker cell inhibitor, is a new-generation antiarrhythmic used to treat sinus tachycardia and angina pectoris in adult patients. In this article, we present three cases of subjects with infantile congenital JET who were admitted to our clinic with a tachycardia-induced cardiomyopathy. The age of the subjects ranged from 52 days to 10 months. Although the cases of tachycardia could not be controlled by multiple antiarrhythmics, including a combination of amiodarone and flecainide combined with either propranolol or digoxin, they were rapidly converted into sinus rhythm with an ivabradine treatment of 0.1-0.2 mg/kg/day. No cardiac or other side effects were observed during ivabradine treatment, and left ventricular functions and rhythms improved within 24 hours. These three cases therefore provide hope that ivabradine may be a suitable standard initial treatment for congenital JET. However, additional research is needed to confirm the validity of these results in other circumstances.

Authors+Show Affiliations

Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Center Hospital, Saglik Bilimleri University, Istanbul, Turkey.Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Center Hospital, Saglik Bilimleri University, Istanbul, Turkey.Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Center Hospital, Saglik Bilimleri University, Istanbul, Turkey.Mersin Woman's and Children's Hospital, Ministry of Health, Mersin, Turkey.Department of Pediatric Cardiology, Adana Numune Research and Education Hospital, Adana, Turkey.Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Center Hospital, Saglik Bilimleri University, Istanbul, Turkey.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

29856078

Citation

Ergul, Yakup, et al. "Ivabradine Is an Effective Antiarrhythmic Therapy for Congenital Junctional Ectopic Tachycardia-induced Cardiomyopathy During Infancy: Case Studies." Pacing and Clinical Electrophysiology : PACE, vol. 41, no. 10, 2018, pp. 1372-1377.
Ergul Y, Ozturk E, Ozgur S, et al. Ivabradine is an effective antiarrhythmic therapy for congenital junctional ectopic tachycardia-induced cardiomyopathy during infancy: Case studies. Pacing Clin Electrophysiol. 2018;41(10):1372-1377.
Ergul, Y., Ozturk, E., Ozgur, S., Ozyurt, A., Cilsal, E., & Guzeltas, A. (2018). Ivabradine is an effective antiarrhythmic therapy for congenital junctional ectopic tachycardia-induced cardiomyopathy during infancy: Case studies. Pacing and Clinical Electrophysiology : PACE, 41(10), pp. 1372-1377. doi:10.1111/pace.13402.
Ergul Y, et al. Ivabradine Is an Effective Antiarrhythmic Therapy for Congenital Junctional Ectopic Tachycardia-induced Cardiomyopathy During Infancy: Case Studies. Pacing Clin Electrophysiol. 2018;41(10):1372-1377. PubMed PMID: 29856078.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ivabradine is an effective antiarrhythmic therapy for congenital junctional ectopic tachycardia-induced cardiomyopathy during infancy: Case studies. AU - Ergul,Yakup, AU - Ozturk,Erkut, AU - Ozgur,Senem, AU - Ozyurt,Abdullah, AU - Cilsal,Erman, AU - Guzeltas,Alper, Y1 - 2018/06/27/ PY - 2017/08/22/received PY - 2017/12/28/revised PY - 2018/05/28/accepted PY - 2018/6/2/pubmed PY - 2019/5/31/medline PY - 2018/6/2/entrez KW - cardiomyopathy KW - infant KW - ivabradine KW - junctional ectopic tachycardia SP - 1372 EP - 1377 JF - Pacing and clinical electrophysiology : PACE JO - Pacing Clin Electrophysiol VL - 41 IS - 10 N2 - Junctional ectopic tachycardia (JET) is a rare form of arrhythmia that is most commonly seen during infancy. JET is continuous and incessant, characterized by persistently high heart rates that may result in impaired cardiac function and tachycardia-induced cardiomyopathy. Despite the availability of multiple antiarrhythmic treatments, including flecainide and amiodarone, management of JET is generally very difficult. Catheter ablation has a high risk of atrioventricular block and it may require the placement of a pacemaker. Ivabradine, also known as a cardiac pacemaker cell inhibitor, is a new-generation antiarrhythmic used to treat sinus tachycardia and angina pectoris in adult patients. In this article, we present three cases of subjects with infantile congenital JET who were admitted to our clinic with a tachycardia-induced cardiomyopathy. The age of the subjects ranged from 52 days to 10 months. Although the cases of tachycardia could not be controlled by multiple antiarrhythmics, including a combination of amiodarone and flecainide combined with either propranolol or digoxin, they were rapidly converted into sinus rhythm with an ivabradine treatment of 0.1-0.2 mg/kg/day. No cardiac or other side effects were observed during ivabradine treatment, and left ventricular functions and rhythms improved within 24 hours. These three cases therefore provide hope that ivabradine may be a suitable standard initial treatment for congenital JET. However, additional research is needed to confirm the validity of these results in other circumstances. SN - 1540-8159 UR - https://www.unboundmedicine.com/medline/citation/29856078/Ivabradine_is_an_effective_antiarrhythmic_therapy_for_congenital_junctional_ectopic_tachycardia_induced_cardiomyopathy_during_infancy:_Case_studies_ L2 - https://doi.org/10.1111/pace.13402 DB - PRIME DP - Unbound Medicine ER -