Abstract 11946: AV Nodal Reentrant Tachycardia in Very Young Children
Introduction: AV Nodal Reentrant Tachycardia (AVNRT) typically occurs in adolescents and adults with little information available about AVNRT in young children. Furthermore, although ablation therapy is the standard of care for this arrhythmia, limited outcome data exists in these pts.
METHODS: We retrospectively studied all pts with AVNRT in our center who underwent an EP study between 2005 and 2012. Pts were stratified by age ≤10 yrs (younger AVNRT) or >10 yrs (older AVNRT). EP characteristics, SVT inducibility, residual slow pathway conduction, success rates, complications, and recurrences were compared. Inducible AVNRT was defined as > 2 consecutive echo beats. The younger AVNRT pts were also compared to all ablation pts with unidirectional retrograde accessory pathways (URAP) in the same age range.
RESULTS: A total of 275 pts were studied. There were 38 younger AVNRT pts (7.7 ± 1.5 yrs, range 4.2 - 9.8 yrs with 55% female) and 202 older AVNRT pts (14.9 ± 2.1 yrs, range 10.0 - 19.7 yrs with 59% female). Younger AVNRT pts were more likely to present to the ED, but symptoms were otherwise similar between the two groups. Younger pts manifested more robust AV conduction and had a trend towards less inducible AVNRT during EPS. Ablation was attempted in all but one older patient with acute success achieved in all. Recurrences were rare (0 younger and 3 older pts). Complications (one pacemaker for heart block) were rare in the older pts and absent in the younger. When compared to younger AVNRT pts, the 35 URAP pts (7.7 ± 1.7 yrs, range 4.4 - 9.9 yrs with 46% female) had a trend towards more chest pain, but symptoms were otherwise similar. Acute success was achieved in all but 3 URAP pts with no complications seen but 2 subsequent recurrences.
Conclusion: Ablation of AVNRT In children has high success rates and low complication rates, especially in those ≤10 years of age. Recurrence rates are low despite the persistence of single echo beats in more than one third of AVNRT pts.
- © 2013 by American Heart Association, Inc.