Electrophysiologic Studies and Radiofrequency Catheter Ablation of Ectopic Atrial Tachycardia in Children

Toyohara, Keiko; Fukuhara, Hitoo; Ye, Jun; Ozaki, Noriyasu; Nakamura, Yoshihide

doi:10.1007/s00246-010-9809-3

Cited by 36 publications

(33 citation statements)

References 18 publications

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“…Cummings et al showed improved acute ablation success rates with a lower incidence of recurrence using 3D electroanatomic mapping compared to 2D mapping techniques in their patients undergoing RF ablation procedures for pediatric AT . Similarly, Toyohara et al reported acute success in all of their pediatric AT patients (35/35) and 11% recurrence undergoing RF ablation using 3D mapping system . In a recent study, Dieks et al reported acute success in 14 of 16 patients (87.5%) using modern mapping systems .…”

Section: Discussionmentioning

confidence: 99%

Electroanatomic mapping‐guided catheter ablation of atrial tachycardia in children with limited/zero fluoroscopy

Elkiran

Akdeni̇z

Karacan

et al. 2019

Pacing Clinical Electrophis

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Introduction Atrial tachycardia (AT) is an uncommon cause of supraventricular tachycardia in children and it is often resistant to medical therapy. Catheter ablation can be curative in children with AT. However, experience of ablation of pediatric AT is still very limited. The aim of this study, which is the largest series from a single center, was to assess the efficacy and safety of ablation of AT using an electroanatomical‐mapping system. Methods It was a retrospective review of 39 children with AT who underwent catheter ablation procedure using the EnSite Velocity system (St. Jude Medical, St. Paul, MN, USA) between July 2012 and April 2017. Results The mean patient age was 13.32 ± 6.82 years. The location of AT was right sided in 25 and left sided in 13, and both sides in one patient. The mean procedure time was 184.23 ± 60.19 min. Fluoroscopy was not used in 25 of 39 patients. The mean fluoroscopy time in the remaining patients was 5.53 ± 5.22 min. Radiofrequency (RF) ablation was used in 22, cryoablation was used in 10, and both RF and cryoablation were used in seven. Acute success was achieved in 34 patients (87.2%). During a mean follow‐up of 51.35 ± 12.62 months, AT recurred in five patients. These patients underwent second ablation procedures and four of them were successful. Final success was achieved in 33 out of 39 patients (84.6%). There were no complications except for one patient who had an uneventful pericardial needle injury during transseptal puncture without effusion. Conclusions Catheter ablation of AT in children can be performed safely and effectively with a limited fluoroscopy using electroanatomical mapping systems.

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Section: Discussionmentioning

confidence: 99%

Electroanatomic mapping‐guided catheter ablation of atrial tachycardia in children with limited/zero fluoroscopy

Elkiran

Akdeni̇z

Karacan

et al. 2019

Pacing Clinical Electrophis

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“…In some cases, children with FAT refractory to initial treatments undergo a complex clinical course involving multiple medications and catheter procedures. With emerging experience to show that catheter therapies are safe and effective, even in young patients, 21 family choice is often the key determinant for using medical versus ablation therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Toyohara et al 21 reported a series of 35 pediatric FAT patients who had 100% acute success and 11% recurrence with RFA using the CARTO Navigation System (Biosense Webster, Inc, Diamond Bar, CA). Data from Cummings et al 13 showed improved ablation success and recurrence rates with electroanatomic mapping compared with conventional mapping for pediatric FAT.…”

Section: Discussionmentioning

confidence: 99%

Current Management of Focal Atrial Tachycardia in Children

Kang

Etheridge

Kantoch

et al. 2014

Circ: Arrhythmia and Electrophysiology

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Background— Focal atrial tachycardia (FAT) is an uncommon cause of supraventricular tachycardia in children. Incessant FAT can lead to tachycardia-induced cardiomyopathy. There is limited information regarding the clinical course and management of FAT. This study characterizes current management strategies for FAT in children including the prevalence of spontaneous resolution and the role of catheter ablation. Methods and Results— This is a retrospective chart review of pediatric patients with FAT managed between January 2000 and November 2010 at 10 pediatric centers. There were 249 patients with a median age at diagnosis of 7.2 (95% confidence interval, 5.8–10.4) years. Cardiomyopathy was observed in 28%. Resolution of FAT occurred in 89%, including spontaneous resolution without catheter ablation in 34%. Antiarrhythmic medications were used for initial therapy in 154 patients with control of FAT in 72%. Among first-line medications, β-blockers were the most common (53%) and effective (42%). Catheter ablation was successful in 80% of patients. FAT recurrence was less common with electroanatomic mapping compared with conventional mapping techniques (16% versus 35%; P =0.02). Patients were followed for a median of 2.1 (95% confidence interval, 1.8–2.6) years. Conclusions— FAT is managed successfully in most children. Current approaches are variable. Many patients have control of FAT with medications; however, catheter ablation is used for most patients. Spontaneous resolution is common for young children, emphasizing the role for delayed ablation in this group. Ablation is successful for all ages. Lower recurrence occurs when electroanatomic mapping techniques are used.

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“…Catheter ablation was effective in 81% of patients in whom it was used. The use of electroanatomical mapping for ablation improved success (102) and decreased recurrence (103). …”

Section: Aic In Childrenmentioning

confidence: 99%

Arrhythmia-Induced Cardiomyopathies

Gopinathannair

Etheridge

Marchlinski

et al. 2015

Journal of the American College of Cardiology

296

116

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Arrhythmia-induced cardiomyopathy (AIC) is a potentially reversible condition in which left ventricular dysfunction is induced or mediated by atrial or ventricular arrhythmias. Cellular and extracellular changes in response to the culprit arrhythmia have been identified, but specific pathophysiological mechanisms remain unclear. Early recognition of AIC and prompt treatment of the culprit arrhythmia using pharmacological or ablative techniques results in symptom resolution and recovery of ventricular function. Although cardiomyopathy in response to an arrhythmia may take months to years to develop, recurrent arrhythmia can result in rapid decline in ventricular function with development of heart failure, suggesting residual ultrastructural abnormalities. Reports of sudden death in patients whose left ventricular ejection fraction have normalized cast doubt on the complete reversibility of this condition. Several aspects of AIC, including specific pathophysiological mechanisms, predisposing factors, optimal therapeutic strategies to prevent ultrastructural changes, and long-term risk of sudden death remain unresolved and need further research.

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Electrophysiologic Studies and Radiofrequency Catheter Ablation of Ectopic Atrial Tachycardia in Children

Cited by 36 publications

References 18 publications

Electroanatomic mapping‐guided catheter ablation of atrial tachycardia in children with limited/zero fluoroscopy

Electroanatomic mapping‐guided catheter ablation of atrial tachycardia in children with limited/zero fluoroscopy

Current Management of Focal Atrial Tachycardia in Children

Arrhythmia-Induced Cardiomyopathies

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