Radiofrequency Catheter Ablation of Accessory Atrioventricular Pathways in Infants and Toddlers ≤ 15 kg.

Abstract:

:Accessory atrioventricular pathways (AP) are the most common substrate for paroxysmal supraventricular tachycardia in infants and small children. Up-to-date data on AP ablation in infants and small children are limited. The aim of the present study was to gain additional insight into radiofrequency (RF) catheter ablation of AP in infants and toddlers focusing on efficacy and safety in patients with a body weight of ≤ 15 kg. Since 10/2002, RF ablation of AP was performed in 281 children in our institution. Indications, procedural data as well as success and complication rates in children with a body weight ≤ 15 kg (n = 22) were compared with children > 15 kg (n = 259). Prevalence of structural heart anomalies was significantly higher among children ≤ 15 kg (27 vs. 5.7 %; p = 0.001). Procedure duration (median 262 vs. 177 min; p = 0.001) and fluoroscopy time (median 20.6 vs. 14.0 min; p = 0.007) were significantly longer among patients ≤ 15 kg. Procedural success rate did not differ significantly between the two groups (82 vs. 90 %). More RF lesions were required for AP ablation in the smaller patients (median 12 vs. 7; p = 0.019). Major complication rate was significantly higher in children ≤ 15 kg (9 vs. 1.1 %; p = 0.05) with femoral vessel occlusion being the only major adverse event in patients ≤ 15 kg. Catheter ablation of AP in children was effective irrespective of body weight. In children ≤ 15 kg, however, procedures were more challenging and time-consuming. Complication rate and number of RF lesions in smaller children were higher when compared to older children.

journal_name

Pediatr Cardiol

journal_title

Pediatric cardiology

authors

Backhoff D,Klehs S,Müller MJ,Schneider H,Kriebel T,Paul T,Krause U

doi

10.1007/s00246-016-1365-z

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

892-8

issue

5

eissn

0172-0643

issn

1432-1971

pii

10.1007/s00246-016-1365-z

journal_volume

37

pub_type

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