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Radiofrequency catheter ablation for the treatment of supraventricular tachycardias in children and adolescents

Published online by Cambridge University Press:  19 August 2008

Pedro Iturralde ,
Luís Colín ,
Sergio Kershenovich ,
Milton E. Guevara ,
Argelia Medeiros ,
Alfonso Buendia  and
Fause Attie
Pedro Iturralde*
Affiliation:
Departments of Electrophysiology and Paediatric Cardiology, Instituto Nacional de Cardiologia “Ignacio Chavez”, México DF, Mexico
Luís Colín
Affiliation:
Departments of Electrophysiology and Paediatric Cardiology, Instituto Nacional de Cardiologia “Ignacio Chavez”, México DF, Mexico
Sergio Kershenovich
Affiliation:
Departments of Electrophysiology and Paediatric Cardiology, Instituto Nacional de Cardiologia “Ignacio Chavez”, México DF, Mexico
Milton E. Guevara
Affiliation:
Departments of Electrophysiology and Paediatric Cardiology, Instituto Nacional de Cardiologia “Ignacio Chavez”, México DF, Mexico
Argelia Medeiros
Affiliation:
Departments of Electrophysiology and Paediatric Cardiology, Instituto Nacional de Cardiologia “Ignacio Chavez”, México DF, Mexico
Alfonso Buendia
Affiliation:
Departments of Electrophysiology and Paediatric Cardiology, Instituto Nacional de Cardiologia “Ignacio Chavez”, México DF, Mexico
Fause Attie
Affiliation:
Departments of Electrophysiology and Paediatric Cardiology, Instituto Nacional de Cardiologia “Ignacio Chavez”, México DF, Mexico
*
Pedro Iturralde MD, Department of Electrophysiology, Instituto Nacional de Cardiologia “Ignacio Chavez”, Juan Badiano I, Tlalpan, 14080 México DF.Mexico, Tel: (52) 5–573–2911; Fax: (52) 5–5730.
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Abstract

We report our experience in radiofrequency catheter ablation between April, 1992 and December, 1998, in which we treated 287 parients less than 18 years of age (mean 14.3±3.1 years) with supraventricular tachycardia. Accessory pathways were the arrhythmic substrate in 252 of the patients (87.8%), the patients having a total of 265 accessory pathways. Atrioventricular nodal re-entry was the cause of tachycardia in 26 patients (9.0%), while atrial flutter was detected in the remaining 9 patients (3.1%). We were able successfully to eliminate the accessory pathway in 236 patients (89%), but 25 patients had recurrent arrhythmias. Ablation proved successful in all cases of atrioventricular node re-entry tachycardia, the slow pathway being ablated in 25 patients, and the fast pathway in only one case. Recurrence of the arrhythmia occurred in three patients (11.5%). We performed a second ablation in these children, all then proving successful. The ablation was successful in all cases of atrial flutter, with one recurrence (11.1%). Overall, therefore, ablation was immediately successful in 271 patients (94.4%), with a recurrence of the arrhythmia in 29 cases (10.7%). The incidence of serious complications was 2.09% There was one late death due to infective endocarditis, 3 patients suffered complete heart block, 1 had mild mitral regurgitation, and 1 patient developed an haematoma in the groin. We conclude that radiofrequency catheter ablation can now be considered a standard option for the management of paroxysmal supraventricular tachycardias in children and young adults.

Keywords

Radiofrequency catheter ablationaccessory pathwayschildrenyoung adults
Type
Original Articles
Information
Cardiology in the Young , Volume 10 , Issue 4 , July 2000 , pp. 376 - 383
Copyright
Copyright © Cambridge University Press 2000

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