Abstract:
Introduction. In recent years radiofrequency catheter ablation (RFCA) has become a standard of care treatment for
children and young adults with supraventricular and ventricular tachyarrhythmias. The aim of this study is to evaluate
the short-term follow-up of RFCA for ventricular and supraventricular tachyarrhythmias in the pediatric age group.
Materials and methods. A total of 63 pediatric patients (mean age at the time of the procedure 12.9±6.7 years, weight
47.98±13.2 Kg), were referred for electrophysiologic study (EPS) and RFCA between April 2004 and April 2018.
The electrophysiologic study was performed in a tertiary center using a modified simple technique with the right femoral
approach and 2 catheters 5 and 6 French one for stimulation and one for mapping. Referral for the RFCA procedure was
done according to the recent guidelines: Class I: WPW syndrome and recurrent and/or symptomatic SVT and age
>5 years; WPW syndrome and palpitations with inducible sustained SVT during EPS, age >5 years; Class IIb: WPW
syndrome and recurrent and/or symptomatic SVT and age <5 years.
Results. A total of 68 EPS procedures were performed in 63 patients. Referral for WPW syndrome in 22 patients
(34.9%), atrioventricular node reentry in 20 patients (31.7%), concealed accessory pathways in 8 patients (12.7%), atrial
tachycardia in 3 patients (4.8%), atrial flutter in 1 patient (1.6%), permanent ventricular tachycardia was the reason
RF ablation in 1 patient (1.6%), premature ventricular beats in 2 patients (3.2%). RFCA was performed under general
sedation in 5 patients (7.9%), the rest of the procedures were under exclusively local anesthesia. RFCA success rate was
97.1%, with an arrhythmia recurrence rate of 5.9%. No complications occurred during procedures. In 1 patient (1.6%)
with WPW syndrome the mechanical induced atrial fibrillation with hemodynamical compromise needed electrical
shock therapy for rhythm control. Mean duration of RFCA was 103.7 min, with a mean radiation exposure time of about
10.5 min and a mean dose of about 1582 μGy/m². A three-dimensional mapping system was needed in 3 RFCA procedures.
Conclusion. Radiofrequency catheter ablation is a safe and highly successful option of treatment for the supraventricular
and ventricular tachyarrhythmias in pediatric patients. The use of the modified simple technique reduces the
risk for major complications.
Description:
Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, Iasi, Romania, Pediatric Cardiology Clinic, “Saint Maria” University Hospital, Iasi, Romania