Adjunctive ivabradine in combination with amiodarone: A novel therapy for pediatric congenital junctional ectopic tachycardia

Dieks, Jana-Katharina; Klehs, Sophia; Müller, Matthias; Paul, Thomas; Krause, Ulrich

doi:10.1016/j.hrthm.2016.03.015

Cited by 56 publications

(55 citation statements)

References 25 publications

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“…Pediatric congenital JET is a narrow QRS tachycardia that often occurs during infancy. Due to its incessant nature and persistent high heart rate, it results in the deterioration of cardiac function and tachycardia‐induced cardiomyopathy . The JET mechanism is thought to be an automatic focus that begins in the vicinity of the AV junction .…”

Section: Discussionmentioning

confidence: 99%

“…Beta blockers, digoxin and flecainide, are the most preferred agents in combination therapy with amiodarone. Nevertheless, many studies have shown that it is almost impossible to completely control tachycardia, and morbidity and mortality rates related to JET are still high …”

Section: Discussionmentioning

confidence: 99%

“…In humans, electrophysiological studies of ivabradine have indicated very little effect on atrial and ventricular refractoriness or on the conduction system . In animal models, the expression of HCN channels is shown not only in the sinoatrial node but also in the AV node . The presence of HCN channels in the junctional pacemaker cells is an indicator that ivabradine can be used in congenital JET patients …”

Section: Discussionmentioning

confidence: 99%

“…In animal models, the expression of HCN channels is shown not only in the sinoatrial node but also in the AV node . The presence of HCN channels in the junctional pacemaker cells is an indicator that ivabradine can be used in congenital JET patients …”

Section: Discussionmentioning

confidence: 99%

“…Ivabradine, known as a cardiac pacemaker cell inhibitor, is a new‐generation antiarrhythmic used to treat inappropriate sinus tachycardia and angina pectoris in adult patients . Two case studies have previously indicated that ivabradine can be used off‐label as pediatric congenital JET treatment . In this article, we present three cases in which individuals with congenital JET were successfully treated with ivabradine.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Ivabradine is an effective antiarrhythmic therapy for congenital junctional ectopic tachycardia‐induced cardiomyopathy during infancy: Case studies

Ergül¹,

Öztürk²,

Özgür³

et al. 2018

Pacing Clinical Electrophis

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%