Transcatheter ablation for pediatric tachyarrhythmias using radiofrequency electrical energy

Radiofrequency ablation is a promising therapeutic option for difficult tachycardias in patients of all ages. Conditions in the pediatric age group that appear most amenable to the technique include accessory pathways and ectopic focus tachycardias, but the list is likely to expand with further experience. Until all long-term risks have been better explored, our institutional policy is to restrict RF ablation to symptomatic children who have failed at least one through trial of pharmacologic control. When a choice must eventually be made between potent antiarrhythmic drugs with variable efficacy and side effects, or an involved and costly surgical procedure, transcatheter ablation would appear to be a reasonable, if not preferred, alternative.