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Background: Frequency of Kawasaki disease (KD) in infants is low in almost all countries. These patients are at higher risk of developing cardiac complications., Aim: To evaluate the clinical features, treatment used and cardiac outcome in infants under one year of age attending for KD in a third level pediatric hospital in Mexico City, Mexico., Methods: A cross-sectional study was conducted in our hospital from August 1995 to August 2019. We analyzed the clinical features, laboratory results, treatment used and cardiac outcomes in infants younger than one year of age and compared them with older patients., Results: We included 687 patients, 152 were younger than one year of age (22.1%). There was a delayed diagnosis in younger patients with an increased frequency of incomplete clinical presentations. Coronary artery abnormalities were most common in younger infants who also had an increased frequency of giant coronary artery aneurysms. Two patients in the younger group died in the acute phase of KD of myocardial infarction., Conclusions: Diagnosis of KD in infants younger than 1 year of age is a clinical challenge with an increased rate of incomplete clinical presentations and also an increased risk of development of severe cardiac complications.

Introduction: QT interval prolongation is associated with ventricular arrhythmias and sudden death syndrome., Objective: To determine the value of QTc interval in healthy newborns in a general hospital in Jalisco, Mexico, and their outcome during their first months of life., Methods: The study included healthy newborns from March to November 2016, in the Hospital General of Occidente in Jalisco, Mexico. A 12-lead electrocardiogram was performed at a speed of 25mm/s during the first 48h of life. The QT interval was measured in lead DII, and the QTc interval was calculated using the Bazett formula. Patients detected with QTc prolongation were assessed monthly with an ECG and echocardiogram. If they persisted with prolonged QTc interval, they were re-evaluated at 6 months with an ECG, 24h Holter, and electrocardiography study on parents and siblings. Those who persisted with prolonged QTc interval were evaluated with an ECG at 9 months., Results: The study included 548 patients. The mean QTc interval at birth was 459 ms; during this period 33 patients has a QTc greated that 470 ms; which were evaluated monthly with a new electrocardiographic study, obtaining a mean QTc interal of 446 ms. At 6 months 16 patients were evaluated, with a mean QTc interval of 434ms. At 9 months, 6 patients were found to have a mean QTc interval of 438ms, and only 4 patients persisted with a prolonged QTc interval., Conclusions: The QTc interval in our population is prolonged compared to other populations and with a gradual return to normal., (Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.)

Objectives: To describe the cardiac manifestations in the acute phase of patients with Kawasaki disease treated in a third level Children's hospital in Mexico City, Mexico., Methods: A cross-sectional study was conducted in patients with a diagnosis of Kawasaki disease treated in this hospital from August 1995 to December 2016. Information included patient demographics, clinical features, treatment used, electrocardiographic findings, extra-coronary echocardiographic findings, and the development of coronary artery aneurysms in the acute phase of the disease., Results: The study included 508 cases of Kawasaki disease, with a mean age at diagnosis of 37.64±35.56 months (range from 2 to 200 months). Almost two-thirds (65.4%) of the patients were male, with a male/female ratio of 1.88:1. Complete Kawasaki disease was diagnosed in 79.2% of cases. Almost all cases (92.4%) received intravenous immunoglobulin. Twenty-eight patients (5.5%) developed arrhythmias, ST changes developed in 29 patients (5.6%), and 5 patients presented with ischaemic changes. In the initial echocardiographic evaluation, 51 patients (9.9%) were diagnosed with myocarditis, 72 patients (14.0%) with pericarditis and 77 cases (15.0%) developed pericardial effusion. Coronary artery anomalies were detected in 169 cases (32.9%). 32 cases were diagnosed as giant coronary aneurysms. Four patients died from cardiac complications in the acute phase of the disease., Conclusions: There has been an increase in the diagnosis of Kawasaki disease in Mexico. They presented with more cardiac complications than reported in literature. An increased knowledge of Kawasaki disease is required in Mexico in order to establish the cardiac outcomes of this group of patients., (Copyright © 2018 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.)

Kawasaki disease (KD) is one of the most common vasculitic disorders in children. The diagnosis is made based on the presence of clinical criteria. We present an exceptional case that fulfilled the clinical criteria of KD except the presence of fever. We consider that the criteria should be revised, with fever not to be considered as an obligate criterion. The similarities of KD with recurrent toxin-mediated perineal erythema are discussed, the latter being a possible attenuated form of KD.

We report the results of radiofrequency catheter ablation in 203 patients under 18 years of age with supraventricular tachyarrhythmias between April 1992 and June 1997. The presence of an accessory pathway caused the tachyarrhythmia in 181 patients (89.1%) with a total of 187 accessory pathways; atrioventricular nodal reentry caused the arrhythmia in 18 patients (8.8%) and atrial flutter in only 4 patients (1.9%). We eliminated the accessory pathway in 171 patients (91.4%), 23 patients showed recurrence of the tachycardia and we had complications in 4 patients (2.1%). The procedure was successful in the treatment of the atrioventricular nodal reentry in the 18 cases, with ablation of the slow pathway in 17 cases and in only one patient of the fast pathway, one patient showed total A-V block, and recurrence of the arrhythmia in 3 cases (16.6%). Finally the procedure was successful in the 4 cases of atrial flutter with one recurrence (25%). In the total of the series, the radiofrequency catheter ablation was successful in 193 patients (95%), with recurrence of the arrhythmia in 27 cases (13.3%) and with complications in only 5 patients (2.6%). Radiofrequency catheter ablation is a safe and effective procedure for the definitive treatment of supraventricular tachyarrhythmias in children.