Related Experiment Videos
[Catheter ablation of accessory pathways in patients with congenital cardiopathies]
F Benito Bartolomé1, C Sánchez Fernández-Bernal, V Torres Feced
1Unidad de Arritmias, Hospital Infantil La Paz, Madrid.
Insights
Radiofrequency ablation successfully treated most accessory pathways in pediatric patients with congenital heart defects. Long-term follow-up showed sustained freedom from tachycardia in most patients, indicating a safe and effective treatment.
Area of Science:
- Electrophysiology
- Pediatric Cardiology
- Congenital Heart Disease
Context:
- Catheter ablation for accessory pathways in children with congenital heart defects presents unique challenges due to complex cardiac anatomy.
- Abnormalities in the conduction system can complicate radiofrequency ablation procedures.
Purpose:
- To evaluate the safety and efficacy of radiofrequency ablation for accessory pathways in pediatric patients with congenital heart defects.
Summary:
- Eight pediatric patients (4.5 months to 18 years) with accessory pathways and congenital heart defects underwent radiofrequency ablation.
- Successful ablation was achieved in 89% of accessory pathways initially; one patient required a second procedure for recurrence.
- After a mean follow-up of 30.9 months, 6 of 7 successfully ablated patients remained tachycardia-free.
Impact:
- Radiofrequency ablation is a viable and effective treatment for accessory pathways in pediatric patients with complex congenital heart disease.
- The procedure demonstrates a high success rate and favorable long-term outcomes, with manageable recurrence rates.
Abstract:
The catheter ablation procedure in patients with accessory pathways and congenital heart defects can potentially become complicated because of abnormal anatomy and atypical conduction system. Eight patients ranging in age from 4.5 months to 18 years with accessory pathways and congenital heart defects underwent radiofrequency ablation. The cardiac diseases were diagnosed as Ebstein anomaly (n = 3), cardiac rhabdomyomas (n = 1), double outlet right ventricle (n = 1), endocardial cushion defect, partial form (n = 1), repaired Fallot's tetralogy (n = 1) and interventricular septal defect (n = 1). Six patients had manifest Wolff-Parkinson-White syndrome and 2 had concealed pathways. One patient with Ebstein anomaly had multiple accessory pathways. Radiofrequency ablation was initially successful in eight of the nine accessory pathways (89%). Two procedures were performed in one patient for pathway recurrence. Procedure was unsuccessful in 1 patient with Ebstein anomaly who later had surgical interruption of the accessory pathway. After a mean follow-up of 30.9 +/- 16.4 months, six of the 7 patients in which pathways were successfully ablated are tachycardia-free. One patient had late recurrence of tachycardia and is well controlled by propafenone.