[Radiofrequency ablation of idiopathic left ventricular tachycardia in children]

Nowadays radiofrequency catheter ablation is an alternative to medical treatment in adult patients with idiopathic left ventricular tachycardia.

To asses indications, results and long term follow-up of using this technique in children. : Radiofrequency catheter ablation was performed in five consecutive patients without structural heart disease, mean age 8.6+/-7.1 years (range, 1.3 to 17) and suffering from resistance to medical treatment left ventricular tachycardia (2.4+/-0.9 antiarrhythmic drugs per patient). Palpitations and syncope were the clinical manifestations in four patients while congestive heart failure in the other one. Six types of tachycardia were identified in the five-patient group. All of them responded to intravenous verapamil. There were 3 incessant tachycardias and the other three were paroxysmal ones. The ablation site was selected using activation mapping during tachycardia and pace-mapping. The Tachycardia cycle length was 275+/-123 ms and showed right bundle branch block with superior axis (left in 4 and right in 2 cases). The ablation target was located in the mid-septal region of the left ventricle in 3 cases, in the apical and inferior septal region in 2 other cases and in the anterior free wall in the other one. Local activation times preceded in 33+/-13 ms at QRS beginning and with a 12/12 agreement pattern in 5 cases and 9/12 in 1, in whom ablation was unsuccessful. At follow-up, the 4 patients with effective ablation have been tachycardia-free for 35.8+/-17 months.

Radiofrequency catheter ablation is a useful method of treatment in children with idiopathic left ventricular tachycardia, including those under two years old.