Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-18T15:45:21.319Z Has data issue: false hasContentIssue false
  • English
  • Français

Transcatheter ablation using near-zero fluoroscopy in children with focal atrial tachycardia: a single-centre experience

Published online by Cambridge University Press:  20 July 2020

Sevket Balli  and
Mehmet Kucuk Open the ORCID record for Mehmet Kucuk [Opens in a new window]
Sevket Balli
Affiliation:
Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training & Research Hospital, University of Health Sciences, Istanbul, Turkey
Mehmet Kucuk*
Affiliation:
Department of Pediatric Cardiology, Samsun Training and Research Hospital, Samsun, Turkey
*
Author for correspondence: Assoc. Prof. Mehmet Küçük, Department of Pediatric Cardiology, Samsun Training and Research Hospital, 100. yil bulvari Kadin Dogum ve Cocuk Hastaliklari Hizmet Binasi Ilkadim, Samsun, Turkey. Tel: +90362 2309100; Fax: +90362 3111500. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Focal atrial tachycardia accounts for up to 10–15% of supraventricular tachycardiasubstrates in patients < 30 years. In this study, we aimed to demonstrate the outcome of transcatheter ablation procedures performed through three-dimensional electroanatomic mapping systems using minimal fluoroscopy in a paediatric cohort with focal atrial tachycardia.

Methods:

Forty-nine consecutive patients with focal atrial tachycardia who underwent an electrophysiologic study and a transcatheter ablation procedure in our hospital from September 2014 to February 2020 were included into the study.

Results:

The mean weight of the patients was 48.63 ± 15.4 kg, and the mean age was 14.56 ± 3.5 (5.5–18.4) years. The tachycardia was defined as incessant in 26 patients. Thirteen patients had left ventricular systolic dysfunction with a mean left ventricular ejection fraction of 38.47 ± 12.4% on echocardiography. The mean procedure time was 148.7 ± 94.5 minutes. Transseptal puncture and thus fluoroscopy were required in nine patients. The mean fluoroscopy time was 4.51 ± 5.9 minutes. No fluoroscopy was needed in ablations performed in the right atrium. The acute success rate of the ablation procedures was 97.9%. The mean follow-up period was 50.71 ± 23.5 months. Recurrence was noted in two patients (4.2%).

Conclusion:

The outcomes of three-dimensional electroanatomic mapping-guided transcatheter ablation procedures are promising with high acute success, low recurrence and complication rates in children with focal atrial tachycardia. The use of fluoroscopy can be significantly decreased with three-dimensional mapping systems in this group of patients.

Keywords

Focal atrial tachycardiaelectroanatomic mappingchildrenzero-floro
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 9 , September 2020 , pp. 1266 - 1272
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kang, KT, Etheridge, SP, Kantoch, MJ, et al.Current management of focal AT in children: a multicenter experience. Circ Arrhythm Electrophysiol 2014; 7: 664–670.CrossRefGoogle ScholarPubMed
Toyohara, K, Fukuhara, H, Yoshimoto, J, Ozaki, N, Nakamura, Y.Electrophysiologic studies and radiofrequency catheter ablation of ectopic atrial tachycardia in children. Pediatr Cardiol. 2011; 32: 40–46. doi: 10.1007/s00246-010-9809-3CrossRefGoogle ScholarPubMed
Dieks, JK, Müller, MJ, Schneider, HE, et al.Catheter ablation of pediatric focal atrial tachycardia: ten-year experience using modern mapping systems. Pediatr Cardiol 2016; 37: 459–464.CrossRefGoogle ScholarPubMed
Cummings, RM, Mahle, WT, Strieper, MJ, et al.Outcomes following electroanatomic mapping and ablation for the treatment of ectopic atrial tachycardia in the pediatric population. Pediatr Cardiol 2008; 29: 393–397.CrossRefGoogle ScholarPubMed
Elkiran, O, Akdeniz, C, Karacan, M, Tuzcu, V.Electroanatomic mapping-guided catheter ablation of AT in children with limited/zero fluoroscopy. Pacing Clin Electrophysiol 2019; 42: 453–457.CrossRefGoogle ScholarPubMed
Manolis, AS, Wang, PJ, Estes, NA 3rd. Radiofrequency catheter ablation for cardiac tachyarrhythmias. Ann Intern Med 1994; 121: 452–461.CrossRefGoogle ScholarPubMed
Rosso, R, Kistler, PM.Focal atrial tachycardia. Heart 2010; 96: 181–185.CrossRefGoogle ScholarPubMed
Lee, G, Sanders, P, Kalman, JM.Catheter ablation of atrial arrhythmias: state of the art. Lancet 2012; 380: 1509–1519.CrossRefGoogle ScholarPubMed
Balli, S, Kucuk, M, Orhan Bulut, M, Kemal Yucel, I, Celebi, A.Transcatheter cryoablation procedures without fluoroscopy in pediatric patients with atrioventricular nodal reentrant tachycardia: a single-center experience. Acta Cardiol Sin 2018; 34: 337–343.Google ScholarPubMed
Liu, XY, Jacobsen, PK, Pehrson, S, Chen, X.Catheter ablation of focal AT using remote magnetic navigation. J Invasive Cardiol 2018; 30: 126–132.Google ScholarPubMed
Kipp, RT, Boynton, JR, Field, ME, et al.Outcomes during intended fluoroscopy-free ablation in adults and children. J Innov Card Rhythm Manag 2018; 9: 3305–3311.CrossRefGoogle ScholarPubMed
Smith, G, Clark, JM.Elimination of fluoroscopy use in a pediatric electrophysiology laboratory utilizing three-dimensional mapping. Pacing Clin Electrophysiol 2007; 30: 510–518.CrossRefGoogle Scholar
Busch, S, Forkmann, M, Kuck, KH, et al.Acute and long-term outcome of focal AT ablation in the real world: results of the German ablation registry. Clin Res Cardiol 2018; 107: 430–436.CrossRefGoogle ScholarPubMed
Manolis, AS, Lazaridis, K.Focal AT ablation: highly successful with conventional mapping. J Interv Card Electrophysiol 2019; 55: 35–46.CrossRefGoogle ScholarPubMed
Kugler, JD, Danford, DA, Houston, KA, Felix, G.Pediatric radiofrequency ablation registry of the pediatric radiofrequency ablation registry of the pediatric electrophysiology society pediatric radiofrequency catheter ablation registry success, fluoroscopy time, and complication rate for supraventricular tachycardia: comparison of early and recent eras. J Cardiovasc Electrophysiol 2002; 13: 336–341.CrossRefGoogle ScholarPubMed
Wu, KL, Chiu, SN, Lu, CW, Tseng, WC, Wu, MH.Acute outcomes for cryoablation in pediatric patients with perinodal tachyarrhythmia: single center report. ActaCardiol Sin 2019; 35: 134–143.Google ScholarPubMed