title: Radiofrequency catheter ablation for the treatment of supraventricular tachycardias in children and adolescents.
abstract: We report our experience in radiofrequency catheter ablation between April, 1992 and December, 1998, in which we treated 287 patients less than 18 years of age (mean 14.3 +/- 3.1 years) with supraventricular tachycardia. Accessory, pathways were the arrhythmic substrate in 252 of the patients (87.8%), the patients having a total of 265 accessory pathways. Atrioventricular nodal re-entry was the cause of tachycardia in 26 patients (9.0%), while atrial flutter was detected in the remaining 9 patients (3.1%). We were able successfully to eliminate the accessory pathway in 236 patients (89%), but 25 patients had recurrent arrhythmias. Ablation proved successful in all cases of atrioventricular node re-entry tachycardia, the slow pathway being ablated in 25 patients, and the fast pathway in only one case. Recurrence of the arrhythmia occurred in three patients (11.5%). We performed a second ablation in these children, all then proving successful. The ablation was successful in all cases of atrial flutter, with one recurrence (11.1%). Overall, therefore, ablation was immediately successful in 271 patients (94.4%), with a recurrence of the arrhythmia in 29 cases (10.7%). The incidence of serious complications was 2.09%. There was one late death due to infective endocarditis, 3 patients suffered complete heart block, 1 had mild mitral regurgitation, and 1 patient developed an haematoma in the groin. We conclude that radiofrequency catheter ablation can now be considered a standard option for the management of paroxysmal supraventricular tachycardias in children and young adults.
authors.affiliation: Department of Electrophysiology, Instituto Nacional de Cardiologia Ignacio Chavez, México DF, Mexico.
authors.forename: P
authors.initials: P
authors.lastname: Iturralde
authors.forename: L
authors.initials: L
authors.lastname: Colin
authors.forename: S
authors.initials: S
authors.lastname: Kershenovich
authors.forename: M E
authors.initials: ME
authors.lastname: Guevara
authors.forename: A
authors.initials: A
authors.lastname: Medeiros
authors.forename: A
authors.initials: A
authors.lastname: Buendia
authors.forename: F
authors.initials: F
authors.lastname: Attie
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001282:Atrial Flutter / Q000209:etiology; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012008:Recurrence; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000209:etiology; D014927:Wolff-Parkinson-White Syndrome / Q000209:etiology