Accessory atrioventricular pathways and atrioventricular nodal reentrant tachycardia in teenagers. Electrophysiologic characteristics and radiofrequency catheter ablation.
Accessory pathway-mediated tachyarrhythmias and AV nodal reentrant tachycardia represent a large portion of supraventricular tachycardia in younger patients. Reports comparing electrophysiologic characteristics and results of radiofrequency ablation between teenagers and adults from the same electrophysiology laboratory are rare, and these deserve further study. This study included 49 teenage patients (mean age 17 +/- 3 years, range from 10 to 20) and 1008 adult patients (mean age 50 +/- 13 years, range from 21 to 92) referred for electrophysiologic study and radiofrequency ablation for treatment of accessory pathway-mediated and AV nodal reentrant tachycardia. The results showed that: (1) mean duration of tachyarrhythmia was shorter in teenagers, but incidences of syncope, cardioversion for hemodynamic compromise and associated cardiovascular diseases were similar in both groups; (2) teenagers had a higher incidence of right-sided free wall accessory pathways (34.1% vs 14.9%, p = 0.048) and better conduction properties of accessory pathways and AV nodal pathways; (3) fast-slow and multiple forms of AV nodal reentrant tachycardia were significantly less frequent (p = 0.026) in teenagers, whereas atrial fibrillation with ventricular preexcitation was common in adults; (4) success rate, incidence of recurrent tachycardia, total procedure time, radiation exposure time and number of radiofrequency pulses for successful ablation did not differ significantly between teenagers and adults.


CONCLUSIONS
(1) different electrophysiologic characteristics were found between teenagers and adults; and (2) radiofrequency ablation was effective and safe in teenagers with paroxysmal supraventricular tachycardia.
Tai
C T
CT
Department of Medicine, National Yang-Ming University, School of Medicine, Taiwan, R.O.C.
Chen
S A
SA
Chiang
C E
CE
Wu
T J
TJ
Cheng
C C
CC
Chiou
C W
CW
Lee
S H
SH
Ueng
K C
KC
Wang
S P
SP
Chiang
B N
BN
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods; D002648:Child; D004594:Electrophysiology; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000503:physiopathology / Q000601:surgery*