Radiofrequency catheter ablation can be performed with high success rates and very low complication rates in children and adolescents.
OBJECTIVE
Radiofrequency catheter ablation is a standard treatment for tachyarrhythmia in children. Recently, several centres using cryoenergy for ablation have reported high success and low complication rates, but an increased risk of recurrence of arrhythmia. The aim of this study was to report success, complications and recurrence rates for radiofrequency catheter ablation in children under current conditions.


METHODS
A retrospective cohort study of 333 consecutive children undergoing radiofrequency catheter ablation over the last two decades.


RESULTS
Radiofrequency catheter ablation was performed successfully in 96.7% of patients, but was significantly less successful in patients with a right anterior or right anterolateral accessory pathway (81.8%). Overall mortality was 0%; there was only one (0.3%) major complication, a pericardial haemorrhage, and only 2.8% of the patients developed minor vascular complications at the puncture site. None of the patients developed a persistent atrioventricular block. Over a median observation time of 4.3 years (0.1; 17.8), recurrence of arrhythmia occurred in 9.3% of all patients, but 50% of children with right lateral accessory pathways.


CONCLUSIONS
Radiofrequency catheter ablation can be performed with high success and very low complication rates in children. Recurrence rates are substantially lower than those reported for cryoablation in the literature.
Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
Andreas
A
Hanslik
Azra
A
Mujagic
Elisabeth
E
Mlczoch
Heinz
H
Gössinger
Marianne
M
Gwechenberger
Bernhard
B
Richter
Manfred
M
Marx
Sulaima
S
Albinni
D000293:Adolescent; D017115:Catheter Ablation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013610:Tachycardia / Q000601:surgery*; D016896:Treatment Outcome
Ablation; Arrhythmia; Children; Radiofrequency; Recurrence