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Efficacy and Safety of Radiofrequency Catheter Ablation of Tachyarrhythmias in 123 Children Under 3 Years of Age
Author(s) -
JIANG HE,
LI XIAOMEI,
LI YANHUI,
ZHANG YAN,
LIU HAIJU
Publication year - 2016
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12888
Subject(s) - medicine , tachycardia , atrial flutter , catheter ablation , cardiology , cardiomyopathy , atrial tachycardia , atrioventricular reentrant tachycardia , ablation , anesthesia , accessory pathway , heart failure
Background The risk‐benefit ratio of radiofrequency catheter ablation (RFCA) in infants and toddlers remains controversial. Experience with RFCA in these patients is limited. This work is intended to describe the efficacy and safety of RFCA in children under 3 years of age with tachycardia complicated by drug resistance, drug intolerance, or tachycardia‐induced cardiomyopathy. Methods We retrospectively reviewed data from 123 consecutive children under 3 years of age (mean, 2.3 ± 0.8 years; weight, 13.6 ± 2.8 kg) with tachycardia complicated by drug resistance, drug intolerance, or tachycardia‐induced cardiomyopathy; the children underwent an electrophysiology study between 1994 and 2014 at our center. Fifteen children had congenital heart disease, and 27 children were under 1 year of age. Among the 109 children who underwent RFCA, acute success rate (no inducible arrhythmia before procedure completion), 2‐year rate of symptomatic tachyarrhythmia recurrence, and complication rate were assessed. Results Among the 123 children studied, 76.4% had atrioventricular reentrant tachycardia, 5.7% had atrioventricular nodal reentrant tachycardia, 2.4% had focal atrial tachycardia, 6.5% had atrial flutter, and 4.1% had idiopathic left ventricular tachycardia. For RFCA, the acute success rate was 94.5%, and the 2‐year recurrence rate was 6.8%, without any major complications. Conclusion RFCA appears to be an effective and safe therapeutic option in selected small children with tachycardia resistant to conventional medical management, tachycardia complicated by drug intolerance, or tachycardia‐induced cardiomyopathy.