Cardiac anatomic considerations in pediatric electrophysiology

Although interventional electrophysiology and the use of radiofrequency energy to cure various arrhythmias primarily developed in the adult population, similar applications in children have grown dramatically over the last decade. The anatomic basis for various arrhythmias is critically important for the pediatric ablationists to appreciate. Such understanding allows the use of alternative technique to affect cure while avoiding complications. Further, because of the relatively small heart and less thick myocardium in children, without the appreciation of the underlying cardiac anatomic relationships, collateral injury, for example to the arterial system, may occur. In this review, the cardiac anatomic consideration important in approaching various supraventricular and ventricular arrhythmias in the normal heart is discussed.