[Treatment of cardiac arrhythmia with radiofrequency in pediatrics].
OBJECTIVE
The use of radiofrequency ablation of cardiac arrhythmias in pediatrics requires demonstration that the technique is effective and devoid of significant complications. In this study we present our experience in the ablation of cardiac arrhythmias in children and adolescents.


METHODS
Between January 1992 and January 1997 we performed a total of 1,543 radiofrequency ablation procedures. Of these, 130 were performed in 117 patients younger than 18 years of age (58 were younger than 14 years old). Indication for ablation was the presence of drug refractory recurrent paroxysmal supraventricular tachycardia in 112 patients and permanent ventricular preexcitation in 5 asymptomatic patients. Final diagnosis in the 112 symptomatic patients was: 4 atrial tachycardias, 21 atrio-ventricular nodal reentrant tachycardias, 53 Wolff-Parkinson-White (WPW) syndromes, 33 orthodromic tachycardias using a concealed accessory pathway and 1 idiopathic left ventricular tachycardia.


RESULTS
The initial ablation procedure was effective in 109/117 patients (93%) with a total duration of 90 +/- 31 minutes, using 16 +/- 11 minutes of radioscopy and a median of 4 radiofrequency applications. During follow-up, recurrence occurred in 9 patients (8%). In 7 of them and in 6 of those with an unsuccessful initial procedure, a second effective procedure was performed in 11/13 patients. Finally, radiofrequency ablation was effective in 111/117 patients (95%). We observed a single complication in a 15 year old girl who presented a thrombosis of the right femoral artery requiring balloon recanalization. Comparison of these results with those in the adult population showed no difference in terms of effectiveness, recurrences or complications.


CONCLUSIONS
Radiofrequency ablation of cardiac arrhythmias in pediatric and young patients can be safely and effectively done. Results are similar to those obtained in adults suggesting that indications for ablation can also be similar.
Brugada Terradellas
J
J
Unidad de Arritmias, Hospital Clínic, Barcelona.
Rissech Payret
M
M
Mont Girbau
L
L
Fita Rodríguez
G
G
Bartrons Casas
J
J
Matas Avellà
M
M
Mortera Pérez
C
C
Navarro-López
F
F
D000293:Adolescent; D001145:Arrhythmias, Cardiac / Q000145:classification / Q000601:surgery*; D017115:Catheter Ablation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000601:surgery; D013614:Tachycardia, Paroxysmal / Q000601:surgery; D013617:Tachycardia, Supraventricular / Q000601:surgery; D014927:Wolff-Parkinson-White Syndrome / Q000601:surgery
Tratamiento de arritmias cardíacas con radiofrecuencia en pediatría.