Multiple Ablation Targets in Children: Multiple Accessory Pathways and Coexistent Arrhythmia.

Area of Science:

• Pediatric Cardiology
• Electrophysiology
• Cardiac Arrhythmias

Background:

• Multiple accessory pathways (MAPs) and coexisting arrhythmias are rarely documented in pediatric populations.
• Limited data exists on the characteristics and ablation outcomes for children with multiple ablation targets.

Purpose of the Study:

• To evaluate pediatric patients requiring multiple ablation applications for coexisting arrhythmias and MAPs.
• To analyze the characteristics of these complex cases and the procedural outcomes.

Main Methods:

• Retrospective analysis of ablation procedures performed between March 2009 and December 2018.
• Inclusion of 52 pediatric patients (age 4-18) with MAPs and/or coexistent arrhythmias undergoing ablation for multiple targets.

Main Results:

• The incidence of MAPs was 4.6% and coexistent arrhythmias was 2.5% among pediatric ablation patients.
• Overall success rate was 94.5% for pathways/foci and 88.4% for patients, with recurrence rates of 4.5% and 7.6%, respectively.
• Complication rates were low (1.8% overall, 3.8% for patients), with two events noted.

Conclusions:

• The incidence of multiple arrhythmogenic foci and MAPs in children is higher than anticipated.
• A structured diagnostic approach is crucial for managing complex pediatric arrhythmias.
• Ablation outcomes in children with MAPs and coexistent arrhythmias are comparable to those with single targets.