[Accessory pathway ablation in children: indications and results]
F Benzakin1, B Brembilla-Perrot
1Service de cardiologie, hôpital cardiologique, CHU de Brabois, Vandœuvre-les-Nancy, France.
Annales De Cardiologie Et D'Angeiologie
|June 14, 2011
Summary
Radiofrequency ablation for accessory pathways (AP) is effective in children and teenagers. Indications include malignant forms or symptoms, but elective procedures may be delayed until adolescence to minimize risks.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Cardiac Ablation
Context:
- Accessory pathway (AP) ablation is a primary treatment for preexcitation syndrome (PS).
- Concerns regarding radiation exposure and catheterization complications exist for pediatric patients.
- Indications for AP ablation in young children require careful consideration.
Purpose:
- To evaluate the indications and outcomes of radiofrequency AP ablation in pediatric and adolescent populations.
- To compare ablation results between children with and without spontaneous malignant forms of PS.
- To assess the impact of age on ablation success rates and recurrence.
Summary:
- Electrophysiological studies were conducted on 145 patients (ages 5-18) with PS.
- Ablation was performed in 66 children, with higher rates of malignant forms, faster AP conduction, and reentrant tachycardia in the ablated group.
- Recurrence rates were higher in younger patients (15±3 years), suggesting age-related factors influence success.
Impact:
- The study recommends AP ablation for spontaneous malignant forms, symptomatic cases, or competitive athletes.
- Elective ablations may be deferred until adolescence to optimize outcomes and reduce risks.
- Timely ablation for malignant forms is crucial, as evidenced by a reported fatality in an untreated patient.
