Efficacy of radiofrequency catheter ablation for premature ventricular contractions in children
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Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
Yue-E He1, Yue-Zhen Xue1, Abdulla Gharbal1
1Children's Heart Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China.
Insights
Transcatheter radiofrequency ablation (RFCA) is a safe and effective treatment for pediatric ventricular premature contractions (PVCs), demonstrating a high success rate and minimal complications. This procedure improves cardiac function with a low recurrence rate, enhancing ventricular premature treatment safety.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Interventional Cardiology
Background:
- Ventricular premature contractions (PVCs) can impact cardiac function in children.
- Transcatheter radiofrequency ablation (RFCA) is an established treatment for arrhythmias.
- Evaluating RFCA's safety and efficacy in pediatric populations is crucial.
Purpose of the Study:
- To assess the efficacy and safety of RFCA for treating PVCs in children.
- To analyze intraoperative ventricular fibrillation (VF) countermeasures.
- To enhance the safety of pediatric ventricular premature treatment.
Main Methods:
- Retrospective analysis of 75 children undergoing RFCA for PVCs (2010-2019).
- Collection of clinical data including demographics, PVC characteristics, and cardiac function (ejection fraction, LVEDD).
- Paired t-tests used to compare pre- and post-ablation cardiac function.
Main Results:
- RFCA achieved a 90.67% success rate (68/75 patients).
- Significant improvement in left ventricular ejection fraction (LVEF) post-ablation (69.13% vs. 66.21%, P=0.012).
- One instance of intraoperative VF occurred, managed successfully; low recurrence rate (2.94%) over mean 39-month follow-up.
Conclusions:
- Pediatric RFCA for PVCs is safe and effective, with a low complication and recurrence rate.
- Intraoperative VF is manageable by catheter repositioning and precise origin identification.
- RFCA offers a valuable therapeutic option for children with PVCs, improving cardiac outcomes.
Purpose:
This study evaluated the efficacy and safety of transcatheter radiofrequency ablation (RFCA) in treating ventricular premature contractions (PVCs) in children, summarized the countermeasures during intraoperative ventricular fibrillation (VF), and improved the safety of ventricular premature treatment.
Methods:
A retrospective analysis was conducted on 75 children with PVCs who received RFCA in the Second Affiliated Hospital of Wenzhou Medical University from January 2010 to April 2019. Data including age, sex, body weight, ejection fraction, left ventricular end diastolic diameter, burden and number of PVCs/24 h, origin of PVCs, and its complications were collected. Paired t test was used to compare changes in cardiac function before and after surgery.
Results:
Among the 75 cases treated with RFCA, 68 were successfully ablated, giving a success rate of 90.67%. After ablation, the left ventricular ejection fraction (LVEF) of the children was 69.13 ± 3.81%, which was significantly higher than that before surgery (69.13 ± 3.81% vs. 66.21 ± 3.22%, P = 0.012). One of the patients experienced VF during the operation, with no other complications. The initial locus of origin was the anterior septum of the right ventricular outflow tract, but VF occurred during the ablation process. Mean follow-up time was 39 ± 33 months, with two recurrent cases (2.94%).
Conclusions:
Performing RFCA in children is safe and effective, with a low recurrence rate and few complications. VF is not an indication to cease surgery; the key to eliminating complications is repositioning the catheter and finding a more accurate origin point.
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