Editorial [ Current Trends in the Treatment of Supraventricular Tachycardia in Pediatric Age Executive Editors: S. Novo and G. Barbaro ]

In pediatric age supraventricular tachiarrhythmias represent one of the most common cause of admission in cardiology units. Supraventricular arrhythmias may significantly influence the normal growth of a child with significant psycho-social implications. Pediatric cardiologists should be aware about the arrhythmias they face in their clinical practice. Moreover, they should know the possible risks related to specific arrhythmias and use the most efficacious therapeutic strategy with a correct knowledge of antiarrhythmic drugs. In this issue of Current Pharmacological Design the most recent knowledges on pathophysiology, diagnosis and treatment of supraventricular tachyarrhythmias in pediatric age are reviewed and discussed by recognized opinion leaders in the field. Calabro et al. [1] and Vignati et al. [2] carefully analyze the complex pathophysiological mechanisms responsible for arrythmias in pediatric age focusing on the diagnostic tools to be used for a correct characterization of sopraventricular tachycardia (e.g. accessory or doubles pathways) even before birth. Mongiovi et al. [3], based on their sound clinical experience, report the diagnostic and therapeutic guidelines to be used in fetus with supraventricular tachycardia. Karpawich et al. [4] define a general profile of the possible therapeutic solutions according to the natural history of supraventricular arrhythmias in pediatric age. Ratnasamy et al. [5] report the therapeutic algorythms regarding the atrio-ventricular reentry (the most common cause of supraventricular thachycardia in children), whereas Pappone et al. [6] discuss about the need to treat asymptomatic children with ventricular preexcitation at risk for sudden death and on the need to revise the current guidelines, even on the basis of an international survey performed among 111 electrophysiologic centers worldwide. Bouhouch et al. [7] define the principal therapeutic guidelines for nodal reentry tachycardia, the incidence of which may increase in the first years of life. The authors discuss about the need of a long-term pharmacological treatment considering the low mortality risk in the patients affected by this arrhythmia. Fazio et al. [8] analyze the pathophysiological mechanisms of atrial fibrillation and atrial flutter, which are uncommon arrhythmias in pediatric age, defining the principal clinical and therapeutic guidelines. Maid et al. [9] and Sulafa [10] analyze the important problem of the use of antiarrhythmics in pediatric age. Maid et al. focus on the problem of experimentation of new antiarrhythmics and on the written consent to use these drugs in children, with related ethical and clinical implications. Sulafa describes the principal collateral effects of antiarrhythmics in pediatric age, with a careful analysis of the interaction among drugs. Finally, De Santis et al. [11] analyze the nonpharmacological therapy in children with supraventricular tachycardia, comparing the different techniques of ablation (radiofrequency, cryoablation) and their correct use in pediatric age. We would like to thank all the authors for their contributions by providing significant insights based on their clinical experience in pediatric cardiology. It's our hope that the issue be helpful for the scientific and clinical community working in this area. References [1] Calabro M, Cerrito M, Luzza F, Oreto G. Supraventricular tachycardia in infants: epidemiology and clinical management. Curr Pharm Des 2008; 14(8): 723-728. [2] Vignati G, Annoni G. Chacaterization of tachycardia in infants: clinical and instrumental diagnosis. Curr Pharm Des 2008; 14(8): 729-735. [3] Mongiovi M, Pipitone S. Supraventricular tachycardia in fetus: how can we treat? Curr Pharm Des 2008; 14(8): 736-742. [4] Karpawich P, Pettersen M, Gupta P, Shah N. Infants and children with tachycardia: natural history and drug administration. Curr Pharm Des 2008; 14(8): 743-752. [5] Ratnasamy C, Rossique-Gonzalez M,Young ML. Pharmacological therapy in children with atrioventricular reentry: which drug? Curr Pharm Des 2008; 14(8): 753-761. [6] Pappone C, Radinovic A, Santinelli V. Sudden death and ventricular preexcitation: is it necessary to treat the asymptomatic patients? Curr Pharm Des 2008; 14(8): 762-765. [7] Bouhouch R, El Houari T, Fellat I,Arharbi M. Pharmacological therapy in children with nodal reentry tachycardia: when, how and how long to treat the affected patients? Curr Pharm Des 2008; 14(8): 766-769. [8] Fazio G, Visconti C, D'Angelo L, Novo G,Barbaro G, Novo S. Pharmacological therapy in children with atrial fibrillation and atrial flutter. Curr Pharm Des 2008; 14(8): 770-775. [9] Maid G,Guerchicoff M, Falconi M, de Arenaza D. Written consent to use the drug in children. The problem of off-label drugs. Curr Pharm Des 2008; 14(8): 776-781. [10] Sulafa AK. Collateral effects of antiarrhythmics in paediatric age. Curr Pharm Des 2008; 14(8): 782-787. [11] De Santis A, Fazio G, Silvetti MS,Drago F. Transcatheter ablation of supraventricular tachycardias in pediatric patients. Curr Pharm Des 2008; 14(8): 788-793.