Radiofrequency Catheter Ablation in Children with Supraventricular Tachycardias: Intermediate Term Follow up Results

Abstract

The Purpose of the StudyRadiofrequency (RF) catheter ablation represents an important advance in the management of children with cardiac arrhythmias and has rapidly become the standard and effective line of therapy for supraventricular tachycardias (SVTs) in pediatrics. The purpose of this study was to evaluate the intermediate term follow up results of radiofrequency catheter ablation in treatment of SVT in pediatric age group.MethodsA total of 60 pediatric patients (mean age = 12.4 ± 5.3 years, ranged from 3 years to 18 years; male: female = 37:23; mean body weight was 32.02 ± 12.3 kg, ranged from 14 kg to 60 kg) with clinically documented SVT underwent an electrophysiologic study (EPS) and RF catheter ablation at Children’s Hospital Mansoura University, Mansoura, Egypt during the period from January 2008 to December 2009 and they were followed up until October 2011.ResultsThe arrhythmias included atrioventricular reentrant tachycardia (AVRT; n = 45, 75%), atrioventricular nodal reentrant tachycardia (AVNRT; n = 6, 10%), and atrial tachycardia (AT; n = 9, 15%). The success rate of the RF catheter ablation was 93.3% for AVRT, 66.7% for AVNRT, and 77.8% for AT, respectively. Procedure-related complications were infrequent (7/60, 11.7%), (atrial flutter during RF catheter ablation (4/60, 6.6%); ventricular fibrillation during RF catheter ablation (1/60, 1.6%); transient complete heart block during RF catheter ablation (2/60, 3.3%)). The recurrence rate was 8.3% (5/60) during a follow-up period of 34 ± 12 months.ConclusionRF catheter ablation is an effective and safe method to manage children with SVT.

Electrophysiological predictors of propafenone efficacy in prevention of atrioventricular nodal re-entrant and atrioventricular re-entrant tachycardia

“…However, Vassilikos et al showed that non-cardiologists (general practitioners and internists) who are involved in the acute and long-term management of SVT rely more on antiarrhythmic drugs and tend to underestimate the role of ablation therapy for the long-term management of SVT (31). RF ablation therapy is increasingly used in pediatric patients with SVTs, however, antiarrhythmic therapy is still the first choice (usually guided on the results of transesophageal atrial pacing technique), in which propafenone is one of the first choices and has good efficacy in termination of tachycardias (32,33). All this points to the importance of antiarrhythmics for the treatment of supraventricular tachycardias, and therefore to the importance of propafenone, which has proven to be efficient in our study as well as several previous studies, although they included a small number of patients (23,27,28).…”

Diagnosis and Treatment of Supraventricular Tachyarrhythmia in Pediatric Population: A Review Article

“…Radiofrequency ablation (RFA) using the traditional radiofrequency energy to heat and destruct the site of origin of the SVT mechanism has been more widely applied in children since the 1990s [3]. It is now considered as the fi rst line of management for many children with SVT and offering the prospect of cure of the arrhythmia and avoidance of drugassociated side effects.…”

“…Variable mechanisms of SVT exist; we concentrated on the three commonest forms occurring in children which are: atrioventricular re-entry tachyarrhythmia (AVRT), atrioventricular nodal re-entry tachyarrhythmia (AVNRT), and atrial tachyarrhythmia (AT) [3].…”

Initial experience of catheter ablation for cardiac arrhythmias in children and adolescents at a newly built ablation centre

“…The main aetiology for cardiac arrhythmias in adults is myocardial damage due to coronary disease. In children, arrhythmia is rather inherited and closely associated with changes in the development of the cardiac conduction system [1], and supraventricular tachycardia (SVT) is responsible for 95% of cases [2]. Despite this fact, data about the heart rhythm disturbances in children are often extrapolated from the adult population.…”