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Related Concept Videos

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

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Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Electrophysiological characterization of the Bachmann bundle region using 3D electroanatomical mapping and peak frequency analysis during pacemaker lead implantation.

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Pulsed field ablation for the interventional treatment of atrial fibrillation: a scientific statement of the European Heart Rhythm Association of the European Society of Cardiology, the Heart Rhythm Society, the Asia Pacific Heart Rhythm Society, the Latin American Heart Rhythm Society, and the Canadian Heart Rhythm Society.

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Related Experiment Video

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Redo accessory pathway ablation in the pediatric population.

M Cecilia Gonzalez Corcia1,2, Graham Stuart3, Mark Walsh3

  • 1Department of Paediatric Cardiology, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol, BS2 8BJ, UK. cecilia.gonzalezcorcia@uhbristol.nhs.uk.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|November 23, 2021
PubMed
Summary

Recurrence after paediatric accessory pathway ablation stems from factors like poor contact and mapping. New techniques and technologies improve success rates to over 98% for long-term outcomes.

Keywords:
Accessory pathwayFailed ablationPediatric arrhythmiasWPW

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Pediatric Medicine

Background:

  • Accessory pathway ablation in children has a reported recurrence rate of 5%.
  • Investigating the causes of recurrence is crucial for improving long-term success.

Purpose of the Study:

  • To identify reasons for recurrence and failure in paediatric accessory pathway ablations.
  • To share techniques that enhance long-term success rates.

Main Methods:

  • Analysis of 39 paediatric patients undergoing repeat accessory pathway ablation.
  • Evaluation of pathway characteristics and procedural data from initial and repeat ablations.

Main Results:

  • Recurrence causes included poor contact (60% left lateral) and inadequate mapping (40% left lateral).
  • For right lateral pathways, poor contact caused 70% of failures.
  • Cryoablation and low radiofrequency energy contributed to >75% of failures in antero-septal/para-Hisian locations.
  • Successful strategies involved contact force catheters and specific radiofrequency applications.
  • Deep or epicardial pathway location (37%) was a key issue in postero-septal cases, addressed by irrigated tip catheters or targeted lesions.

Conclusions:

  • Paediatric accessory pathway ablation failures are multifactorial, related to pathway anatomy and available technology.
  • Improved understanding of anatomy, meticulous mapping, and advanced technologies are key to achieving >98% success.