title: Low temperature and low energy radiofrequency modification of atrioventricular nodal slow pathways in pediatric patients.
abstract: OBJECTIVE
  To report our experience using low temperature and energy in the modification of the slow pathway in pediatric patients with atrioventricular nodal reentrant tachycardia.
  
  
  BACKGROUND
  A concern in performing a slow pathway modification is the possible damage of the normal AV conduction system. Lesion size has been shown to have a linear relationship with temperature. Previous reports have used energy of 25-50 W that generate temperatures of 60 degrees C -70 degrees C for successful procedures.
  
  
  METHODS
  Report of results of attempted AV nodal slow pathway modification in 17 consecutive pediatric patients < 15 years of age at The Children's Hospital of Philadelphia from April 1995 to November 1997 using low temperature and energy.
  
  
  RESULTS
  There were 18 successful slow pathway modifications with 1 recurrence in 17 patients. The maximum energy used during successful lesions was 32.7 +/- 13.8 W (range 15-50 W) with a mean energy of 26.4 +/- 13.3 W (range 12-48 W). The peak temperature during these lesions was 55.1 degrees C +/- 4.1 degrees C (range 48 degrees C-64 degrees C) with a mean temperature of 47.9 degrees C +/- 2.7 degrees C (range 44 C-540C). The mean number of radiofrequency lesions required for a successful modification was 5.8 +/- 6.7 (median 4.0, range 1-26). Patients have been followed for 2.08 +/- 0.79 years.
  
  
  CONCLUSIONS
  Slow pathway modification can be performed successfully with a low incidence of recurrence in the pediatric patient using low energy and temperature. It is possible that this may lead to smaller lesions.
authors.affiliation: Division of Cardiology, The Children's Hospital of Philadelphia, Pennsylvania 19104, USA. rhodes@email.chop.edu
authors.forename: L A
authors.initials: LA
authors.lastname: Rhodes
authors.forename: T S
authors.initials: TS
authors.lastname: Wieand
authors.forename: V L
authors.initials: VL
authors.lastname: Vetter
mesh_terms: D000293:Adolescent; D001283:Atrioventricular Node / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation / Q000295:instrumentation*; D002648:Child; D004562:Electrocardiography; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D013696:Temperature; D016896:Treatment Outcome