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Catheter ablation of left posterior fascicular ventricular tachycardia in children with limited fluoroscopy exposure

Published online by Cambridge University Press:  06 June 2019

Serhat Koca ,
Celal Akdeniz ,
Mehmet Karacan  and
Volkan Tuzcu
Serhat Koca*
Affiliation:
Pediatric and Genetic Arrhythmia Center, Pediatric Cardiology, Istanbul Medipol University, Istanbul, Turkey
Celal Akdeniz
Affiliation:
Pediatric and Genetic Arrhythmia Center, Pediatric Cardiology, Istanbul Medipol University, Istanbul, Turkey
Mehmet Karacan
Affiliation:
Pediatric and Genetic Arrhythmia Center, Pediatric Cardiology, Istanbul Medipol University, Istanbul, Turkey
Volkan Tuzcu
Affiliation:
Pediatric and Genetic Arrhythmia Center, Pediatric Cardiology, Istanbul Medipol University, Istanbul, Turkey
*
Author for correspondence: Serhat Koca, MD, Kizilay St. no. 4 Sihhiye, Ankara, Turkey. Tel: +90 506 581 8248; E-mail: [email protected]
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Abstract

Introduction:

Catheter ablation of left posterior fascicular ventricular tachycardia in the pediatric population remains challenging, and most studies about this topic have been conducted on adult patients. This study aimed to assess the clinical presentation features and outcomes of catheter ablations performed using limited fluoroscopy with three-dimensional electroanatomic mapping system guidance in a pediatric left posterior fascicular ventricular tachycardia patient group.

Methods:

A total of 20 consecutive patients undergoing left posterior fascicular ventricular tachycardia ablation at a single tertiary centre were enrolled. All children with left posterior fascicular ventricular tachycardia underwent electrophysiological studies using the EnSite NavX system guidance. Ablations were performed during the sinus rhythm based on the Purkinje potentials in all patients.

Results:

The mean patient age was 12.7 years (range 2–16), and the mean patient weight was 51 kg (range 11–84). The mean procedure and median fluoroscopy times were 143.1 minutes and 3.4 minutes, respectively. No fluoroscopy was used in three patients. Acute success was achieved in 19 patients (95%). During a mean follow-up of 38.6 ± 19.35 months, left posterior fascicular ventricular tachycardia recurred in four patients (20%). Repeat ablations were performed successfully in those patients who developed recurrences. No complications were seen.

Conclusions:

Catheter ablation of left posterior fascicular ventricular tachycardia in children can be performed safely and effectively with low fluoroscopy exposure using a three-dimensional electroanatomic mapping system.

Keywords

Left posterior fascicular ventricular tachycardiachildrenPurkinje potentialscatheter ablationthree-dimensional mapping
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 6 , June 2019 , pp. 793 - 799
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Copyright
© Cambridge University Press 2019 

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