Automatic atrial and junctional tachycardias in the pediatric patient: strategies for diagnosis and management.

Unlike supraventricular arrhythmias secondary to reentry, automatic rhythm disturbances in children are rare and more resistant to standard pharmacological therapy. This article reviews strategies for the diagnosis and management of two of the more common pediatric automatic rhythm disturbances, that is, atrial ectopic tachycardia, and junctional ectopic tachycardia. The place of newer nonpharmacological therapy, such as catheter ablation, in the treatment of these entities is beginning to be explored, yet has not been fully delineated. Despite these limitations, there is enough experience with these difficult tachycardias in the pediatric age group to formulate some strategies for optimal diagnosis and management.