Paediatric catheter ablation guided by electroanatomical mapping with limited fluoroscopy: a single centre experience

Catheter ablation is now the preferred early treatment option in children due to its high success rate and low complication rate. The aim of this study was to evaluate the outcomes of patients who underwent electrophysiology studies and a catheter ablation procedure in our centre.

Paediatric patients who underwent catheter ablation in our hospital between 2017 and 2024 and were followed up or referred for ablation from another centre were retrospectively screened. Patients who had an intracardiac defibrillator, pacemaker, or ventricular arrhythmia were excluded from the study. The data were screened from a total of 586 patients (M/F = 300/286). The procedure was applied to 288 (49 %) patients with atrioventricular re-entry tachycardia (Wolf Parkinson White 86.4%-n:249; occult accessory pathway 13.9%- n:39), and to 270 (45%) with atrioventricular nodal re-entry tachycardia. Eleven (1.8%) patients with focal atrial tachycardia, 11 (1.8%) with frequent extrasystole or ventricular tachycardia, 6 (1%) with supraventricular premature beat (SVE), and 2 patients with a Mahaim diagnosis underwent the procedure. Fluoroscopy was used during the procedure in 75 (12.8%) patients, and the mean duration of fluoroscopy was 5.2 ± 3.2 mins (range 0.2-19.6 mins). Of these 75 patients, trans-septal punction was performed on the left side for the procedure to be applied in 71 patients. Of the patients diagnosed with atrioventricular re-entry tachycardia, fluoroscopy was used in 4.

The results of this study of catheter ablation performed at our institution have shown acute success and recurrence rates similar to those of previously published studies.