Interventional electrophysiology in children: a single-center experience
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Published on: May 26, 2015
Pasha Mosaed1, Mohammad Dalili, Zahra Emkanjoo
1Department of Pediatrics, Zanjan University of Medical Sciences, Zanjan, Iran.
Insights
Pediatric catheter ablation for cardiac arrhythmia is effective and low-risk, with a 94.4% success rate. Recurrence and complication rates in children are comparable to adults, supporting ablation over long-term drug therapy.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Cardiac Arrhythmia Management
Background:
- Cardiac arrhythmia ablation techniques in children have advanced, but pediatric procedures remain less common than adult procedures.
- Limited data exists on the success rates and complication profiles of pediatric ablations.
Purpose of the Study:
- To evaluate the efficacy and safety of catheter ablation for cardiac arrhythmias in pediatric patients.
- To compare pediatric ablation outcomes with existing adult data.
Main Methods:
- A retrospective study of 125 catheter ablations performed on 112 pediatric patients between March 2005 and February 2011.
- Success was defined as the abolition of the arrhythmia source post-procedure.
- Recurrence was categorized as early (before discharge) or late (after discharge).
Main Results:
- Overall procedural success rate was 94.4% (118/125), with significantly higher success in atrioventricular nodal reentry tachycardia (AVNRT).
- Recurrence occurred in 6.7% (7/105) of patients, inversely related to body size (P<0.05).
- No mortality was observed; 5 complications occurred but were fully resolved.
Conclusions:
- Catheter ablation is an effective and low-risk treatment for pediatric cardiac arrhythmias.
- Recurrence and complication rates in children are similar to those reported in adults.
- Pediatric patients with significant arrhythmias should be considered for ablation rather than prolonged toxic drug therapy.
Objective:
Ablation techniques of cardiac arrhythmia in children have significantly progressed in the past decade; however, the number of pediatric ablations is still significantly lower than that in adults. Accordingly, there is less information regarding the success rate and complications in this age group.
Methods:
All pediatric ablations conducted between March 2005 and February 2011 at Rajaie Heart Center were studied. Abolishing the arrhythmia source by the end of procedure was considered as success. Recurrences before hospital discharge and those thereafter were named early recurrence and late recurrence, respectively.
Findings:
A total of 125 catheter ablations were performed for 112 patients. Of them 118 (94.4%) procedures were successful. The success rate was significantly higher in the patients with atrioventricular nodal reentry tachycardia (AVNRT). Of 105 patients who continued follow-up program, 7 (6.7%) cases experienced recurrence; the recurrence rate was inversely dependent on the patients' body size (P-value <0.05). There was no mortality. Five cases were complicated during or early after the procedure, all the complications were cured completely.
Conclusion:
Therapeutic electrophysiology in children is an effective and relatively low-risk method. The recurrence and complication rates are similar to those reported in adults. Considering our results and the previous reports, pediatric patients with serious arrhythmia should not be deprived from ablation and should not be exposed to long-term toxic drugs.
