Related Experiment Videos
[Fulguration of accessory pathways in children. Value of two-dimensional echocardiography]
J Clementy1, L Nasciamento, M Gimenez
1Hôpital Cardiologique du Haut-Lévêque, Pessac.
Insights
Transcatheter ablation effectively treated refractory reciprocating tachycardia in children by targeting accessory pathways. This minimally invasive approach offers a safe alternative to surgery for pediatric patients.
Area of Science:
- Cardiology
- Pediatric Electrophysiology
Context:
- Refractory reciprocating tachycardia in children presents a significant clinical challenge.
- Accessory pathways are a common cause of such arrhythmias in pediatric populations.
Purpose:
- To evaluate the safety and efficacy of transcatheter ablation for treating refractory reciprocating tachycardia in children.
- To assess the role of two-dimensional echocardiography in the management of these pediatric patients.
Summary:
- Six children (aged 3-7 years) with refractory reciprocating tachycardia underwent transcatheter ablation targeting accessory pathways.
- Successful ablation or modification of accessory pathways led to tachycardia suppression, with one failure.
- Two-dimensional echocardiography proved valuable for pre-operative evaluation, intra-procedural guidance, and post-operative assessment.
Impact:
- Transcatheter ablation demonstrates feasibility and safety as an alternative to surgical intervention for pediatric refractory reciprocating tachycardia.
- This technique offers a less invasive treatment option, potentially improving outcomes for affected children.
- The study highlights the importance of advanced imaging like echocardiography in optimizing ablation procedures.
Abstract:
Six children (4 boys and 2 girls) aged from 3 to 7 years who had an accessory pathway and were suffering from paroxysmal (n = 4) or permanent (n = 2) refractory reciprocating tachycardia underwent transcatheter ablation of the accessory pathway alone in 5 cases and of the normal and accessory pathways in 1 case. Conduction in the accessory pathway was interrupted in 3 cases and sufficiently modified in 2 cases for the attacks of tachycardia to be suppressed by a simple and previously ineffective medical treatment. There was one failure. The authors underline the value of two-dimensional echocardiography in such cases. This technique is useful in the preoperative evaluation, during catheter insertion, and also in the choice of the electrodes to be used, for the ablation itself and in the search for postoperative lesions. Transcatheter ablation seems to be feasible and safe enough to be offered as an alternative to surgery in the treatment of refractory reciprocating tachycardia in children.