Objectives; Chaotic atrial tachycardia(CAT) is a rare tachyarrhythmia in infants and it may resolve spontaneously in months without evidence of hemodynamic compromise, however, some infants exhibit signs of heart failure or cardiomyopathy. The purpose of this study was to review the clinical characteristics and late outcome in children with CAT.
Methods; During last 17 years, 36 patients were diagnosed as CAT by the electrocardiographic criteria of CAT. Clinical presentations, echocardiograms and long-term courses of these patients were reviewed. Particular attention was paid to evidence of cardiac dysfunction and follow-up cardiac status.
Results; 23 boys and 13 girls presented with CAT. The age at presentation were all below 1 yr(median age 1 month) and 13(36%) patients presented as fetal arrhythmia. 11 (30%)had structural heart diseases. 14 infants(39%) showed signs of congestive heart failure or left ventricular dysfunction at echocardiogram. There was no difference in atrial rates or ventricular rates between patients with and without ventricular dysfunction. Structural heart disease did not have influence on the exhibition of clinical heart failure or left ventricular dysfunction. Ventricular function was recovered in all with dysfunction after resolution of CAT. Sinus rhythm was restored in 4.1 months on the average(1-9 months). During follow-up, there were 2 deaths, not related with tachyarrhythmia.
Conclusions; CAT in children usually occurs in the first months of life and preterm. Significant number of patients exhibited overt congestive heart failure or left ventricular dysfunction. However, long-term outcome was excellent, irrespective of the presence of ventricular function or structural heart disease.