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Accelerated junctional rhythm in children with acute rheumatic fever: is it specific to the disease?

Published online by Cambridge University Press:  22 May 2013

Naci Ceviz ,
Velat Celik ,
Hasim Olgun  and
Mehmet Karacan
Naci Ceviz
Affiliation:
Division of Pediatric Cardiology, Atatürk University School of Medicine, Erzurum, Turkey
Velat Celik
Affiliation:
Department of Pediatrics, Atatürk University School of Medicine, Erzurum, Turkey
Hasim Olgun*
Affiliation:
Division of Pediatric Cardiology, Atatürk University School of Medicine, Erzurum, Turkey
Mehmet Karacan
Affiliation:
Division of Pediatric Cardiology, Atatürk University School of Medicine, Erzurum, Turkey
*
Correspondence to: H. Olgun, Division of Pediatric Cardiology, Atatürk University School of Medicine, Erzurum, Turkey. Tel: +90 442 231 7885; Fax: +90 442 236 1301; E-mail: drholgun@hotmail.com
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Abstract

Objective: During the course of acute rheumatic fever, some electrocardiographic changes are seen. First-degree atrioventricular block is the most common electrocardiographic abnormality. Second- and third-degree atrioventricular block, ventricular tachycardia, and junctional acceleration are also seen. In the present study, the specificity of accelerated junctional rhythm to acute rheumatic fever was investigated. Methods: The study included patients with acute rheumatic fever (Group 1), healthy children who had suffered from recent group A β-haemolytic streptococcal upper respiratory tract infection but did not develop acute rheumatic fever (Group 2), and patients who had other diseases that may affect the joints and/or heart (Group 3). Results: Accelerated junctional rhythm was detected in 10 patients in Group 1, but in none of the patients from Group 2 or 3. Specificity of accelerated junctional rhythm for acute rheumatic fever was 100% and the positive predictive value was 100%. Conclusion: Accelerated junctional rhythm is specific to acute rheumatic fever. Although its frequency is low, it seems that it can be used in the differential diagnosis of acute rheumatic fever, especially in patients with isolated polyarthritis.

Keywords

Acute rheumatic feverelectrocardiographyaccelerated junctional rhythm
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 3 , June 2014 , pp. 464 - 468
Copyright
Copyright © Cambridge University Press 2013 

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References

1. El Said, GM. Rheumatic fever and rheumatic heart disease. In: Garson A, Bricker JT, Fisher DJ, Neish SR (eds). The Science and Practice of Pediatric Cardiology, 2nd edn. Williams & Wilkins, Baltimore, 2007: 1691–1723.Google Scholar
2. Guidelines for the diagnosis of rheumatic fever (1992). Jones Criteria, 1992 update. Special Writing Group of the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease of the Council on Cardiovascular Disease in the Young of the American Heart Association. JAMA 1992; 268: 2069–2073.Google Scholar
3. Ortiz, EE. Acute rheumatic fever. In: Anderson RH, Baker EJ, Macartney FJ, Rigby ML, Shinebourne EA, Taynan M (eds). Paediatric Cardiology. Churchill Livingstone, New York, 2002: 1713–1732.Google Scholar
4. Tani, LY. Rheumatic fever and rheumatic heart disease. In: Allen HD, Driscoll DJ, Shaddy RE, Feltes TF (eds). Moss and Adams Heart Disease in Infants, Children, and Adolescents, Including the Fetus and Young Adult. Lippincott Williams & Wilkins, Philadelphia, 2008: 1256–1280.Google Scholar
5. Clark, M, Keith, JD. Atrioventricular conduction in acute rheumatic fever. Br Heart J 1972; 34: 472–479.Google Scholar
6. Cristal, N, Stern, J, Gueron, M. Atrioventricular dissociation in acute rheumatic fever. Br Heart J 1971; 33: 12–15.Google Scholar
7. Karacan, M, Isıkay, S, Olgun, H, Ceviz, N. Asymptomatic rhythm and conduction abnormalities in children with acute rheumatic fever: 24-hour electrocardiography study. Cardiol Young 2010; 20: 620–630.Google Scholar
8. Sokolow, M. Significance of electrocardiographic changes in rheumatic fever. Am J Med 1948; 5: 365–378.CrossRefGoogle ScholarPubMed
9. Stocker, FP, Czoniczer, G, Massell, BF, Nadas, AS. Transient complete AV block in two siblings during acute rheumatic carditis in childhood. Pediatrics 1970; 45: 850–856.Google Scholar
10. Zalzstein, E, Maor, R, Zucker, N, Katz, A. Advanced atrioventricular conduction block in acute rheumatic fever. Cardiol Young 2003; 13: 506–508.Google Scholar
11. Malik, A, Hassan, G, Khan, GQ. Transient complete heart block complicating acute rheumatic fever. Indian Heart J 2002; 54: 91–93.Google Scholar
12. Freed, MS, Sacks, P, Ellman, MH. Ventricular tachycardia in acute rheumatic fever. Arch Intern Med 1985; 145: 1904–1909.Google Scholar
13. Olgun, H, Ceviz, N. Unusual rhythm problems in acute rheumatic fever: two patient reports. Clin Pediatr 2004; 43: 197–199.Google Scholar
14. Lenox, CC, Zuberbuhler, JR, Park, SC, Neches, WH, Mathews, RA, Zoltun, R. Arrhythmias and Stokes-Adams attacks in acute rheumatic fever. Pediatrics 1978; 61: 599–603.CrossRefGoogle ScholarPubMed
15. Yahalom, M, Jerushalmi, J, Roguin, N. Adult acute rheumatic fever: a rare case presenting with left bundle branch block. Pacing Clin Electrophysiol 1990; 13: 123–127.CrossRefGoogle ScholarPubMed
16. Woo, KS. Bradytachyarrhythmia as the first manifestation of acute rheumatic carditis in an adult. West J Med 1992; 156: 413–415.Google Scholar