title: Radiofrequency catheter ablation of idiopathic left anterior fascicular ventricular tachycardia in children.
abstract: BACKGROUND
  Idiopathic ventricular tachycardia of left anterior fascicular origin (IVT-LAF) is a rare condition, and radiofrequency catheter ablation (RFCA) therapy has not been reported in children.
  
  
  OBJECTIVE
  This study aimed to evaluate the procedures and outcomes of RFCA for pediatric IVT-LAF.
  
  
  METHODS
  Pediatric IVT-LAF cases for which RFCA was performed between June 2006 and May 2012 at our hospital were reviewed.
  
  
  RESULTS
  Of 537 pediatric cases of RFCA, 6 had IVT-LAF; 4 had anterior fascicular involvement only, while 2 had both anterior and posterior fascicular involvement. All 6 of them underwent RFCA at the median age of 8.8 years (range 4.3-14.3 years). RFCA was successful in all patients, but 4 had recurrence and underwent 1-3 additional sessions of RFCA. In a total of 10 RFCA sessions, the overall recurrence rate was 50%. The site of RFCA was determined on the basis of detection of diastolic potential during ventricular tachycardia (7 sessions) or isolated delayed potential during sinus rhythm (1) or by pace mapping (2). During the median follow-up period of 33 months, no further recurrence was reported except for 1 patient, who had a recurrence and was scheduled for additional session at the time of this report. Major complications included 1 case of complete atrioventricular block and 1 case of complete left bundle branch block.
  
  
  CONCLUSIONS
  Despite a high recurrence rate and a few complications, RFCA of the site of isolated delayed potential or diastolic potential, if applied cautiously, is a possible treatment of choice for pediatric IVT-LAF.
authors: Department of Pediatric Electrophysiology. Electronic address: tsugutoshi@me.com.
authors: Tsugutoshi
authors: T
authors: Suzuki
authors: Department of Pediatric Electrophysiology.
authors: Yoshihide
authors: Y
authors: Nakamura
authors: Department of Pediatric Electrophysiology.
authors: Shuichiro
authors: S
authors: Yoshida
authors: Department of Pediatric Electrophysiology.
authors: Yoko
authors: Y
authors: Yoshida
authors: Department of Pediatric Cardiology, Pediatric Medical Care Center, Osaka City General Hospital, Osaka, Japan.
authors: Kae
authors: K
authors: Nakamura
authors: Department of Pediatric Cardiology, Pediatric Medical Care Center, Osaka City General Hospital, Osaka, Japan.
authors: Takeshi
authors: T
authors: Sasaki
authors: Department of Pediatric Cardiology, Pediatric Medical Care Center, Osaka City General Hospital, Osaka, Japan.
authors: Mitsuhiro
authors: M
authors: Fujino
authors: Department of Pediatric Cardiology, Pediatric Medical Care Center, Osaka City General Hospital, Osaka, Japan.
authors: Yuki
authors: Y
authors: Kawasaki
authors: Department of Pediatric Cardiology, Pediatric Medical Care Center, Osaka City General Hospital, Osaka, Japan.
authors: Eiji
authors: E
authors: Ehara
authors: Department of Pediatric Cardiology, Pediatric Medical Care Center, Osaka City General Hospital, Osaka, Japan.
authors: Yosuke
authors: Y
authors: Murakami
authors: Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors: Haruo
authors: H
authors: Shintaku
mesh_terms: D000293:Adolescent; D002036:Bundle of His / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D011183:Postoperative Complications; D012008:Recurrence; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Idiopathic left ventricular tachycardia; Left anterior fascicular ventricular tachycardia; Pediatric; Radiofrequency catheter ablation