Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Pediatric Tachyarrhythmia and Radiofrequency Catheter Ablation: Results From 1993 to 2011

  • Kim, Yeo Hyang (Department of Pediatrics, Keimyung University Dongsan Medical Center) ;
  • Park, Hyoung-Seob (Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center) ;
  • Hyun, Myung Chul (Department of Pediatrics, Kyungpook National University Hospital) ;
  • Kim, Yoon-Nyun (Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center)
  • Published : 2012.11.30
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Abstract

Background and Objectives: We performed a retrospective study to elucidate the frequency of tachycardia mechanisms and the characteristics of accessory pathways (APs), confirmed by radiofrequency catheter ablation (RFCA) in pediatric tachycardia. In addition, we analyzed the efficacy and safety of pediatric RFCA. Subjects and Methods: The authors retrospectively reviewed the records of a total of 260 patients (aged 2 to 18 years) who had undergone RFCA between August 1993 and July 2011 at two medical centers in Daegu. Results: Two hundred and sixty patients underwent 272 RFCAs at less than 18 years of age. Of these 260 patients, 9 patients (3%) were younger than 6 years, and 175 patients (67%) were older than 12 years. The tachycardia mechanisms observed were atrioventricular reentry tachycardia (AVRT) in 175 patients (65%), atrioventricular nodal reentry tachycardia (AVNRT) in 83 patients (30%), ventricular tachycardia in 12 patients (4%), and atrial tachycardia in 2 patients (0.7%). Among the patients with AVRT, there were 94 concealed APs and 81 manifest APs. Left-side APs were more common in concealed APs than in manifest APs (72/94, 77% vs. 33/81, 41%, p<0.001). Sixty- six percent (55/83) of AVNRT cases were located at the M1 and/or M2 sites. Four patients had multiple tachycardia mechanisms (AVNRT+AVRT) and 9 patients had multiple APs. The recurrence rate was 5% (13/272). Of these recurrent cases, 12 patients had AVRT. The overall success rate was 95%. Conclusion: Pediatric RFCA provides a good success rate and an acceptable recurrence. In addition, we suggest that the APs location may be associated with concealed or manifest property of APs.

Keywords

References

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