Related Experiment Video
Updated: Feb 19, 2026
Remote Magnetic Navigation for Accurate, Real-time Catheter Positioning and Ablation in Cardiac Electrophysiology Procedures
Published on: April 21, 2013
Ablation of manifest accessory pathways in pediatric patients: comparison between conventional and non‑radiological
Alejandro Cuesta1, María J Arocena2, José M Moltedo3
1Unidad Académica Cardiología, Hospital de Clínicas, Facultad de Medicina, UdelaR. Montevideo, Cairoli 2026 CP 11600, Montevideo, Uruguay. arritmia@yahoo.com.
Abstract:
The purpose was to evaluate clinical characteristics and outcomes of patients under 18 years of age submitted for an electrophysiological study (EPS) for the presence of a manifest accessory pathway (AP) and to compare conventional versus non‑radiological navigation system (NRNS) technics. An observational, multicenter and analytical study was conducted using Latin American Heart Rhythm Society´s pediatric registry. A total of 746 patients underwent EPS due to manifest AP and were all included. The mean age was 10,5 ± 4,4 years, and 471 (63.1%) were male. There were 68 (9,1%) with a structural heart disease and Ebstein’s anomaly was the most frequent congenital heart disease (CHD). Ablation was attempted in 734 (98.4%) and was successful in 694 (94.6%). A NRNS was used in 218 (28.8%) procedures and radiofrequency was used in 728 (97.6%). There were 22 (2.9%) complications, including complete AV block requiring pacemaker implantation in 2 (0.3%) cases. No deaths were reported. After at least one-year follow-up there were 64 (2.2%) patients with manifest AP recurrence. Patients in NRNS group were older (11,6 ± 3,7 vs., 9,6 ± 4,7 years, p < 0,001), had more CHD (13,5% vs. 6,2%, p = 0,004), required less fluoroscopy (6,9 ± 5,9 vs. 20,2 ± 16,5 min, p < 0,001) and achieved higher acute success (99,1% vs. 92,7%, p < 0,001). There were no differences in complications or recurrences. In the multivariate analysis, only the use of NRNS was independently associated with greater effectiveness (p = 0.019). This study reports clinical characteristics, EPS and ablation in children with manifest AP. Ablation using a NRNS was more effective and required less fluoroscopy, without compromising safety.Capsule Summary: In 746 children undergoing EPS for manifest accessory pathways, ablation showed high effectiveness and low complication rates. Non-radiological navigation systems (NRNS) achieved higher acute success and markedly reduced fluoroscopy without compromising safety. Multivariate analysis identified NRNS as an independent predictor of greater effectiveness.
