title: Feasibility and safety of transseptal puncture procedures for radiofrequency catheter ablation in small children weighing below 30 kg: single-centre experience.
abstract: OBJECTIVE
  Transseptal puncture (TSP) has become a common approach in catheter ablation of arrhythmia originating from the left atrium. In paediatric patients, however, TSP can be a challenge due to narrower access vessels and small left atrial size, and the safety of TSP in smaller children is yet to be understood. The purpose of this study was to retrospectively evaluate the feasibility and safety of TSP in children weighing below 30 kg.
  
  
  RESULTS
  Among 655 paediatric patients who underwent catheter ablation of arrhythmia between July 2009 and April 2015, 43 cases having structurally normal hearts, weighing <30 kg and requiring TSP were included in the study. Age, height, body weight, diagnosis, and complications during TSP and catheter ablation were evaluated. The median age, height, and body weight (range) were 7.0 years (0.3-11.1), 116.8 cm (54.0-138.4 cm) and 21.5 kg (4.3-29.6 kg), respectively. Diagnosis included manifest (n = 27; 62.8%) and concealed accessory pathway (n = 14; 32.6%) and atrial tachycardia (n = 2; 4.6%). In 10 cases (23.2%), TSP using radiofrequency energy was performed. None of the patients had major complications. Pericardial effusion was recorded as a minor complication in one patient (2.3%).
  
  
  CONCLUSIONS
  TSP was feasible, safe, and of low risk of complications in children weighing <30 kg.
authors.affiliation: Department of Pediatric Electrophysiology, Pediatric Medical Care Center, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima- ku, Osaka 534-0021, Japan mrdrshu@yahoo.co.jp.|Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Department of Pediatric Electrophysiology, Pediatric Medical Care Center, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima- ku, Osaka 534-0021, Japan.
authors.forename: Tsugutoshi
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Pediatric Electrophysiology, Pediatric Medical Care Center, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima- ku, Osaka 534-0021, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yoshida
authors.affiliation: Department of Pediatric Electrophysiology, Pediatric Medical Care Center, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima- ku, Osaka 534-0021, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Department of Pediatric Cardiology, Pediatric Medical Care Center, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima- ku, Osaka 534-0021, Japan.
authors.forename: Kae
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Pediatric Cardiology, Pediatric Medical Care Center, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima- ku, Osaka 534-0021, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Department of Pediatric Cardiology, Pediatric Medical Care Center, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima- ku, Osaka 534-0021, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kawasaki
authors.affiliation: Department of Pediatric Cardiology, Pediatric Medical Care Center, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima- ku, Osaka 534-0021, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Ehara
authors.affiliation: Department of Pediatric Cardiology, Pediatric Medical Care Center, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima- ku, Osaka 534-0021, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Murakami
authors.affiliation: Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: Taichi
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Pediatric Electrophysiology, Pediatric Medical Care Center, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima- ku, Osaka 534-0021, Japan.
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Nakamura
mesh_terms: D001145:Arrhythmias, Cardiac / Q000601:surgery*; D001835:Body Weight; D006348:Cardiac Surgical Procedures; D017115:Catheter Ablation; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000033:anatomy & histology; D006346:Heart Septum / Q000601:surgery*; D006801:Humans; D007223:Infant; D007564:Japan; D008297:Male; D010490:Pericardial Effusion / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D011677:Punctures / Q000379:methods*; D012189:Retrospective Studies
keywords: Children; Complication; Radiofrequency catheter ablation; Safety; Transseptal puncture