Short-term Result of Radiofrequency Catheter Ablation in Pediatric Patients with Paroxysmal Tachycardia

Purpose : To find out the efficacy, safety and early complication of radiofrequency catheter ablation(RFCA) in pediatric patients with paroxysmal tachycardia, we compared short-term results of RFCA in pediatric patients to adult patients. Methods : We studied 25 patients(11 pediatric patients, 14 adult patients), who underwent RFCA due to paroxysmal supraventricular tachycardia(PSVT) or idiopathic ventricular tachycardia(VT) from November 1997 to August 1998. We evaluated PSVT or idiopathic VT mechanism and compared total procedure times, total energy durations and complication rates between pediatric patients and adult patients. Results : Among the 25 patients, the mechanisms of tachycardia were atrioventricular reentrant tachycardias in 14 patients, atrioventricular nodal reentrant in 10 patients and idiopathic left ventricular in 1 patient. Among the 11 pediatric patients, atrioventricular reentrant was found in 9 patients, atrioventricular nodal reentrant in 1 patient and idiopathic left ventricular in 1 patient. while among the 14 adult patients, atrioventricular reentrant was found in 5 patients and atrioventricular nodal reentrant in 9 patients. Total procedure time was 190±52 minutes in pediatric patients and 161±49 minutes in adult patients(P=0.17). Total energy duration was 244±223 seconds in pediatric patients and 187±122 seconds in adult patients(P=0.45). There were no major complications related to RFCA except minor hematomas at puncture sites. Conclusion : Considering the total procedure time, total energy duration and complication rates, there were no significant differences between pediatric patients and adult patients. RFCA showed relatively high success rate and one recurrence after initial success. Thus, we consider RFCA is as a good therapeutic modality which can cure tachycardia, especially PSVT. (J Korean Pediatr Soc 2000;43:203-209)

[1]  A. Garson,et al.  Management of the Child with Wolff‐Parkinson‐White Syndrome and Supraventricular Tachycardia: , 1997, Journal of cardiovascular electrophysiology.

[2]  G. Hare Radiofrequency Ablation of Accessory Pathways Associated with Congenital Heart Disease , 1997, Pacing and clinical electrophysiology : PACE.

[3]  G. Hare Indications for Radiofrequency Ablation in the Pediatric Population , 1997 .

[4]  H. Trappe,et al.  Coronary artery involvement early and late after radiofrequency current application in young pigs. , 1997, American heart journal.

[5]  M. I. Cohen,et al.  Electrophysiologic properties of the atrioventricular node in pediatric patients. , 1997, Journal of the American College of Cardiology.

[6]  J. Saul,et al.  Late Enlargement of Radiofrequency Lesions in Infant Lambs: Implications for Ablation Procedures in Small Children , 1994, Circulation.

[7]  J. Kugler Radiofrequency catheter ablation for supraventricular tachycardia. Should it be used in infants and small children? , 1994, Circulation.

[8]  G. V. Van Hare,et al.  Follow-up of radiofrequency catheter ablation in children: results in 100 consecutive patients. , 1994, Journal of the American College of Cardiology.

[9]  D. Danford,et al.  Radiofrequency Catheter Ablation for Tachyarrhythmias in Children and Adolescents , 1994 .

[10]  G. V. Van Hare,et al.  Radiofrequency catheter ablation of supraventricular arrhythmias in patients with congenital heart disease: results and technical considerations. , 1993, Journal of the American College of Cardiology.

[11]  J. Saul,et al.  Catheter ablation of accessory atrioventricular pathways in young patients: use of long vascular sheaths, the transseptal approach and a retrograde left posterior parallel approach. , 1993, Journal of the American College of Cardiology.

[12]  J. Saul,et al.  Transcatheter Ablation of Ectopic Atrial Tachycardia in Young Patients Using Radiofrequency Current , 1992, Circulation.

[13]  K. Kuck,et al.  Radiofrequency current for catheter ablation of accessory atrioventricular connections in children and adolescents. Emphasis on the single-catheter technique. , 1992, Pediatrics.

[14]  J. Strasburger,et al.  Supraventricular tachycardia mechanisms and their age distribution in pediatric patients. , 1992, The American journal of cardiology.

[15]  J. Langberg,et al.  Radiation Exposure During Radiofrequency Catheter Ablation of Accessory Atrioventricular Connections , 1991, Circulation.

[16]  M. Dick,et al.  Use of Radiofrequency Current to Ablate Accessory Connections in Children , 1991, Circulation.

[17]  J. Langberg,et al.  Percutaneous radiofrequency catheter ablation for supraventricular arrhythmias in children. , 1991, Journal of the American College of Cardiology.

[18]  A. Garson,et al.  Supraventricular tachycardia due to Wolff-Parkinson-White syndrome in children: early disappearance and late recurrence. , 1990, Journal of the American College of Cardiology.

[19]  J. Langberg,et al.  Successful Transcatheter Ablation of Congenital Junctional Ectopic Tachycardia in a Ten‐Month‐Old Infant Using Radiofrequency Energy , 1990, Pacing and clinical electrophysiology : PACE.

[20]  F. Morady,et al.  Catheter-induced ablation of the atrioventricular junction to control refractory supraventricular arrhythmias. , 1982, JAMA.

[21]  J J Gallagher,et al.  Catheter technique for closed-chest ablation of the atrioventricular conduction system. , 1982, The New England journal of medicine.

[22]  G. Hare Electrical/Ablational Therapeutic Cardiac Catheterization , 1998, Pediatric Cardiology.