Midseptal and Anteroseptal Accessory Pathway Ablation in Children
László Környei1, Matevž Jan2, Mohammad Ebrahim3
1Gottsegen National Cardiovascular Center, Hungarian Paediatric Heart Center, 1096 Budapest, Hungary.
Journal of Clinical Medicine
|November 27, 2024
Summary
High-risk accessory pathways in children can be effectively treated with cryoablation or radiofrequency ablation using 3D mapping systems, minimizing radiation exposure and achieving high success rates.
Area of Science:
- Cardiology
- Pediatric Electrophysiology
- Medical Technology
Background:
- Accessory pathways (AP) in pediatric patients pose a risk for arrhythmias.
- Minimizing fluoroscopy during ablation procedures is crucial in pediatric care.
Purpose of the Study:
- To evaluate outcomes of ablation for high-risk accessory pathways in pediatric patients.
- To assess the efficacy of 3D mapping systems with minimal fluoroscopy.
Main Methods:
- A multicenter, cross-sectional study involving 111 pediatric patients (2013-2023).
- Utilized 3D mapping systems (predominantly EnSite Precision™) for ablation.
- Compared cryoablation (72.7%) and radiofrequency ablation (27.3%) for anteroseptal and midseptal pathways.
Main Results:
- Overall acute success rate of 89.1% with a 17.2% recurrence rate.
- No significant difference in success rates between anteroseptal and midseptal pathways or energy sources.
- Low complication rate (4.69%) including transient AV block and hematoma. Minimal fluoroscopy used (mean 3 min 45 s).
Conclusions:
- 3D mapping systems enable effective ablation of pediatric accessory pathways with low radiation doses.
- Both radiofrequency and cryoablation are viable options with excellent acute success and low complication rates.
