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[Radiofrequency treatment of tachyarrhythmias in children and adolescents]
J L Martínez1, C M Monedero, E M Alvaro
1Departamento de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid.
Introduction:
Radiofrequency ablation has been extensively used in adults to treat supraventricular and ventricular tachycardia. In children and adolescents few data are available on its safety and efficacy.
Methods:
28 patients (mean age 12.8) with symptomatic tachyarrhythmias underwent catheter ablation; 21 children had atrioventricular accessory pathways (11 right connections, 9 lef connections and one midseptal pathway), 3 had intranodal tachycardia, 2 had ventricular tachycardia and 2 had atrial tachycardia. Only four patients had associated structural anomalies.
Results:
Success rate was 71.4% (20 patients). The success per cents in each group were: in intranodal tachycardias 100%; we failed in the two patients with ventricular tachycardias; in accessory pathways 76.1% and 50% in atrial tachycardia. There were no recurrences of arrhythmia in a mean chase period of 24 months (12-46). Major complications were only observed in one patient who developed a Wallenberg syndrome after ablation.
Conclusions:
Radiofrequency catheter ablation appears to be a safe and effective method to treat arrhythmias in children and adolescents, which in most cases can supersede surgery. Alow incidence of complications is reported, although long term damage on endocardial structures remains yet to be determined.