Naslov
Permanent junctional reciprocatig tachycardia (PJRT) and dilated cardiomyopathy (DCM)

Autori
Malčić, Ivan ; Buljević, Bruno ; Kaltenbruner, W. ; Goldner, Vladimir ; Jelušić, Marija ; Kniewald, Hrvoje ; Jelašić, Dražen ; Rojnic Putarek, Nataša

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Zeitschrift fur Kardiologie / - , 2002

Skup
34. Jahrestagung der Deutschen Gesellschaft fur Padiatrische Kardiologie

Mjesto i datum
Bamberg, Njemačka, 05.08.2002

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Sažetak
We report a 14 year old girl with heart inusufficiency which developed gradually over one month before she was admitted to the hospital. Prior to this, the girl was healthy, in good physical condition. ECG revealed a reentrant tachycardia of PJRT type: change of frequency 130-200/min, retrograde P wave negative in inferior leads, long RP-interval (>0.15s), PR-interval was shorter than RP-interval, finishes in the presence of AV-block, spontaneously continues with acceleration of the sinus frequency. At the same time the child had DCM: cardiomegaly, weakened LV function (ECHO EF 20%, radionuclide ventriculography 10%), thinning of the heart wall (IVS 5 mm, LWPW 5 mm), insufficiency of mitrale valve grade 2, small pericardial effusion. The question is: wether the arrhythmia was a consequence of DCM or was it the case of arrhythmogenic cardiomiopathy. Despite pharmacological therapy, sinus rhythm wasn't achieved. Finally RF-ablation was done. Myocard biopsy explained the ethiology. Light microscopy showed diffuse fibrous changes in myocard. Immunohistochemistry didn't show any inflammatory elements. Immunfluorescency showed high IgG and low C3 and fibrine. Similar changes were on the surface of endocardium and in interstitium. PCR analysis didn't show RNA or DNA virus. After ablation the sinus rythm was achieved, and glucocorticoids were introduced in the therapy to supress immune process in myocard. Three months later the child improved, the whole heart shrunk, heart walls thickened, and EF was 45%. Conclusion: We described a case of PJRT in adolescent caused by chronic inflammatory immune process most probably after virus myocarditis. The sinus rhythm was achieved by RF-ablation. The cause and the consequence could be explained by myocard biopsy. The effect of glucocorticoids in chronic myocarditis will be controled by biopsy.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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