Radiofrequency catheter ablation therapy in the young: current status

Abstract

Since 1989, when radiofrequency ablation was introduced into clinical practice for pediatric patients with supraventricular tachycardias, radiofrequency catheter ablation techniques have evolved as the treatment of choice for many forms of tachycardia in young patients. This review discusses the current status of ablation therapy for the four most common forms of supraventricular tachycardias in children, including tachycardias based on accessory atrioventricular pathways, atrioventricular nodal reentrant tachycardia, atrial ectopic tachycardia and the permanent form of junctional reciprocating tachycardia. In addition, the report will focus on the current status and limitations of ablation therapy of ventricular tachycardias and atrial reentry tachycardias in patients after surgical correction of congenital heart defects.

Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Infants and Toddlers

“…19,20 Nonetheless, the acute success rate (92.6%), major complication rate (3.7%), and recurrence rate (13%) were all comparable to those in our previous report on the whole pediatric population and in other pediatric reports. 1,3,[11][12][13][14]21 The presence of congenital heart disease was not associated with worse outcomes, but this should be interpreted with caution. Most of our patients with congenital heart disease requiring RFCA at such a young age had congenital heart disease other than Ebstein's anomaly, which is notoriously associated with lower success rates and higher recurrence rates.…”

Transvenous cryothermal catheter ablation of re-entry circuit located near the atrioventricular junction in pediatric patients

“…Radiofrequency (RF) ablation for treatment of supraventricular tachycardias (SVTs) in pediatric patients was introduced into clinical practice in the late 1980s (1). Since then, RF ablation has evolved into the treatment of choice for many different tachyarrhythmias in young patients (1)(2)(3)(4)(5)(6)(7)(8).…”

“…Since then, RF ablation has evolved into the treatment of choice for many different tachyarrhythmias in young patients (1)(2)(3)(4)(5)(6)(7)(8). However, despite the success of RF ablation, there are reported safety and efficacy concerns that have been raised.…”

Entstehungsweise und Beeinflussung von tachykarden Herzrhythmusstörungen im Kindesalter

“…Bei Kindern und Jugendlichen mit symptomatischen supraventrikulären Tachykardien stellt die elektrophysiolgische Untersuchung und Katheterablation des anatomischen Substrats eine sinnvolle und kausale Therapie dar [4,5,9,20]. Die Empfehlungen zur Indikation hinsichtlich der Durchführung einer elektrophysiologischen Untersuchung und Katheterablation sind erst kürzlich aktualisiert worden [5].…”