Safety and Efficacy of Open Irrigated‐Tip Catheter Ablation of Wolff‐Parkinson‐White Syndrome in Children and Adolescents

Abstract

RF ablation of APs using open irrigated-tip catheters can be performed in children and adolescents with a high acute and long-term success rate, very short procedure times, and acceptable fluoroscopy times.

Irrigated‐tip catheters for radiofrequency ablation of right‐sided accessory pathways in adolescents

“…Data about the long‐term efficacy of irrigated‐tip RFA catheters in pediatric patients are scarce. In the study of Gulletta et al, no long‐term recurrence was reported using ITC. In the study of Mujovic et al.…”

“…Complications were rare and mostly minor. Earlier studies had reported a considerable risk of atrio‐ventricular (AV) block in septal APs, whereas more recent reports demonstrate that RFA can be performed safely with a low risk of even only transient AV block . We had only five patients with lower midseptum pathways which we found safe enough for our approach.…”

“…However, long‐term ablation success still varies depending on pathway location. Higher success rates are reported for left free‐wall pathways compared to right free‐wall pathways in children and adolescents . Lower success and higher recurrence rates for right‐sided AP are also reported in adults .…”

“…The use of nonfluoroscopic 3‐D mapping in combination with nonirrigated radiofrequency ablation (RFA) of right‐sided APs has been increasingly reported in children and adults . Few data exist about the use of irrigated‐tip catheters (ITCs) for right‐sided APs in children and adolescents, and no systematic data are available about the combination of ITC with a 3‐D mapping system in this age group. We evaluated how ITC changed success and recurrence rates in an adolescent population with right‐sided APs.…”

Two decades of experience on ablation in children with Ebstein’s anomaly

“…The safety and efficacy of irrigated tip catheters have been shown in previous studies, even in the paediatric age group. 23 Irrigated tip catheters create deeper lesions that are a desired effect of the catheter but may cause undesirable complications related to the coronary arteries. The close relation of the right coronary artery with the ridge present in the right atrium of patients with Ebstein's anomaly may lead to coronary lesions during irrigated tip energy application.…”