Abstract 11506: Radiofrequency Catheter Ablation of Tachyarrhythmias in Infants and Toddlers
Background: In recent years, the number of catheter ablations for tachyarrhythmias in children has increased. Particularly, catheter ablation has been performed in infants.
Objectives: We examine results, complications, and issues of catheter ablation in children under age 5.
Subjects: Fifty-seven patients under age 5 undergoing catheter ablation between April 2008 and March 2010. A total of 62 sessions were conducted.
Results: Twenty-six boys and 31 girls. Twenty-seven patients with concomitant congenital heart diseases (27%)
Diagnosis : WPW syndrome (27 patients), Atrio-ventricular nodal reentrant tachycardia: AVNRT (10), Ectopic atrial tachycardia: EAT (5), Ventricular tachycardia: VT (4), Junctional ectopic tachycardia: JET (3), Intra-atrial reentrant tachycardia: IART (4), Atrioventricular reentrant tachycardia due to twin AVN sling (3), and unknown PSVT (1). Age (median±SD): 1.80±1.23 years. Operative duration time (median±SD): 142±57.1 minutes. Fluoroscopic duration time (median±SD): 19.2±12.2 minutes. The number of patients with successful catheter ablation during the initial session was 53/57 (93.0%), 4 (7.5%) of whom had recurrence. All five patients undergoing the second session had successful catheter ablation.
Transient complications: Cardiac arrest in 1 patient (needing ICU management and recovered), transient complete atrioventricular block in 4, perforation in 1 (during Brockenbrough's procedure), and laryngeal edema in 1.
Permanent complication: Complete right bundle brach block in 1 patient.
Discussion: Infants and toddlers undergoing catheter ablation are often resistant to medication and/or often need elimination of substrate for tachycardia before and after radical operations of congenital heart disease. Because infants' physique is small, the number of catheters is limited, and the infants are at risk of catheter ablation complications. However, our study showed very few fatal complications of catheter ablation, and the treatment results were comparable to those in schoolage children and adults.
Conclusions: Catheter ablation is very useful for the treatment of tachyarrhythmias even in infants and toddlers.
- © 2011 by American Heart Association, Inc.