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Risk factors of recurrence and complication in radiofrequency catheter ablation of atrioventricular reentrant tachycardia in children and adolescents

Published online by Cambridge University Press:  18 January 2013

Tien H. Chen ,
Ming-Lung Tsai ,
Po-Cheng Chang ,
Hung-Ta Wo ,
Chung-Chuan Chou ,
Ming-Shien Wen ,
Chun-Chieh Wang ,
San-Jou Yeh  and
Delon Wu
Tien H. Chen*
Affiliation:
Second Division of Cardiology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taipei, Taiwan
Ming-Lung Tsai*
Affiliation:
Second Division of Cardiology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taipei, Taiwan
Po-Cheng Chang
Affiliation:
Second Division of Cardiology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taipei, Taiwan
Hung-Ta Wo
Affiliation:
Second Division of Cardiology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taipei, Taiwan
Chung-Chuan Chou
Affiliation:
Second Division of Cardiology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taipei, Taiwan
Ming-Shien Wen
Affiliation:
Second Division of Cardiology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taipei, Taiwan
Chun-Chieh Wang
Affiliation:
Second Division of Cardiology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taipei, Taiwan
San-Jou Yeh
Affiliation:
Second Division of Cardiology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taipei, Taiwan
Delon Wu
Affiliation:
Second Division of Cardiology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taipei, Taiwan
*
Correspondence to: T. H. Chen, M.-L. Tsai contributed equally to this study. Second Division of Cardiology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, 199 Tung Hwa North Road, Taipei, Taiwan. Tel: +886 3 3281200, ext:8115; Fax: +886 3 33281541.
Correspondence to: T. H. Chen, M.-L. Tsai contributed equally to this study. Second Division of Cardiology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, 199 Tung Hwa North Road, Taipei, Taiwan. Tel: +886 3 3281200, ext:8115; Fax: +886 3 33281541.
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Abstract

Background

To compare potential risk factors for complications and recurrence after radiofrequency catheter ablation in symptomatic atrioventricular reentrant tachycardia in children and adolescents.

Methods

We retrospectively reviewed the data of 213 consecutive patients with symptomatic atrioventricular reentrant tachycardia who underwent both electrophysiological study and radiofrequency catheter ablation, divided these patients into two groups, children (age <12 years) and adolescents (12 ≤ age < 18 years), and compared the location of the accessory pathway, success rate, recurrence rate, complications, presence of congenital heart disease, presence of intermittent ventricular pre-excitation, and presence of Wolff–Parkinson–White syndrome in the two groups.

Results

The position of the accessory pathway was mostly right sided in children (61.3%) and left sided in adolescents (61.5%). Children had significantly more congenital heart disease than adolescents (6.4% versus 0.8%). Univariate analysis showed children or adolescents with right-sided accessory pathways to be 6.84 times and those with accessory pathways on both sides of the septum 25 times more likely to relapse than those with a single accessory pathway. Multivariate analysis indicated that children or adolescents with two accessory pathways were six times, and those with intermittent ventricular pre-excitation nine times more at risk of relapsing following radiofrequency ablation than those with single accessory pathways. All five complications occurred in children.

Conclusions

The findings suggest that the position and number of accessory pathways and presence of intermittent ventricular pre-excitation are related to risks of recurrence of atrioventricular reentrant tachycardia in children and adolescents.

Keywords

Atrioventricular reentrant tachycardiaradiofrequency catheter ablationrisk factorintermittent ventricular pre-excitation
Type
Original Articles
Information
Cardiology in the Young , Volume 23 , Issue 5 , October 2013 , pp. 682 - 691
Copyright
Copyright © Cambridge University Press 2013 

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