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Outcomes of interventional electrophysiology in children under 2 years of age
Christian J Turner1, Kai C Lau, Gary F Sholler
1The Heart Centre for Children, The Children's Hospital at Westmead, Sydney, Australia. christian.j.turner@gmail.com
Insights
Interventional electrophysiology is a safe and effective treatment for infants under 2 years old with difficult-to-treat arrhythmias. This procedure offers a viable therapeutic option when other medical management fails.
Area of Science:
- Pediatric Cardiology
- Cardiac Electrophysiology
Background:
- Limited data exist on interventional electrophysiology safety and efficacy in children under 2 years old.
- Arrhythmias in young children pose significant clinical challenges.
Purpose of the Study:
- To evaluate the efficacy and safety of interventional electrophysiology in infants under 2 years.
- To identify indications, procedural outcomes, and complication rates in this pediatric population.
Main Methods:
- Retrospective review of 23 procedures in 17 infants under 2 years (1995-2009).
- Analysis of indications, procedural details, short- and long-term success, and complications.
- Included patients with and without congenital heart disease.
Main Results:
- Most common indications: drug-resistant arrhythmia (59%) and hemodynamically unstable arrhythmia (41%).
- 88% long-term success rate (15/17 patients) after initial and repeat procedures.
- One non-procedural death and three minor complications; cryotherapy was successfully used in one case.
Conclusions:
- Interventional electrophysiology is a viable therapeutic option for infants under 2 years with refractory arrhythmias.
- The procedure demonstrates favorable safety and efficacy in this young patient group.
Background:
Despite the increasing utilisation of interventional electrophysiology in adults and older children with arrhythmias, there are few data reflecting the safety and efficacy of this procedure in the age group under 2 years.
Aim:
We describe our experience in assessing the efficacy and safety with this group of children.
Methods:
We undertook a retrospective review of all infants under 2 years of age who underwent an interventional electrophysiology procedure between 1995 and 2009 to determine indications, procedural details, short- and long-term success, and complication rate.
Results:
A total of 23 interventional electrophysiology procedures were performed in 17 patients initially under 2 years of age. Of these, three patients had congenital heart disease. The most common indication was arrhythmia resistant to pharmacological agents (59%), with the remaining cases being arrhythmia complicated by cardiovascular instability (41%). There was initial success in 15 patients after the first procedure, with early recurrence in four. Following six repeat procedures, there was long-term success in 15 patients (88%), with three repeat procedures being performed after 2 years of age. There was one non-procedural death related to persisting arrhythmia. There were three minor complications. In one patient, cryotherapy was used successfully.
Conclusions:
The interventional electrophysiology procedure is a viable therapeutic option in infants under 2 years with arrhythmia resistant to other conventional medical management.
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