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Transseptal puncture for radiofrequency catheter ablations of left-sided arrhythmias in a paediatric population.
Cardiol Young. 2017 Mar; 27(2):267-272.CY

Abstract

Puncturing the atrial septum is frequently used in adults. In children, the transseptal puncture is less common, technically more demanding, and the rate of complications is not well described. We studied the feasibility and safety of this procedure in a retrospective analysis of 157 consecutive children undergoing transseptal puncture for radiofrequency catheter ablation of left atrial targets in two tertiary-care centres between 2005 and 2013. The median age of the patients at intervention was 12.5 years (1.1-18 years), with median weight of 42 kg (range 9.0-97.0 kg). Pre-excitation was found in 102 procedures, accessory pathway with exclusively retrograde conduction in 41, focal atrial tachycardia in nine, left-sided permanent junctional/reciprocating tachycardia-like accessory pathways in three, and atypical atrioventricular nodal re-entry tachycardia in two. All the procedures were guided by fluoroscopy. Additional imaging by transoesophageal echocardiography was used in three patients. Successful transseptal puncture was possible in 99.4% of the cases, ablation in 97.4%. The median time, including mapping and radiofrequency ablation, was 120 minutes (range 60-450), the median fluoroscopy time 10.8 minutes (range 1.8-75), and the median radiation dose 3 Gy cm2 (range 0.3-35). In total, five patients (3.2%) had a recurrent arrhythmia during the observation period of a median of 40 months (range 1-103). No complications associated with the transseptal puncture were observed. Transseptal puncture is a feasible and safe procedure in children. This access allows successful and efficient radiofrequency ablation of arrhythmia of the left atrium in the vast majority of the patients and might be considered as the first-line approach in this population.

Authors+Show Affiliations

1Department of Paediatric Cardiology,University Children's Hospital Zurich,Zürich,Switzerland.1Department of Paediatric Cardiology,University Children's Hospital Zurich,Zürich,Switzerland.1Department of Paediatric Cardiology,University Children's Hospital Zurich,Zürich,Switzerland.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

27086493

Citation

Ehrlinspiel, Désirée M., et al. "Transseptal Puncture for Radiofrequency Catheter Ablations of Left-sided Arrhythmias in a Paediatric Population." Cardiology in the Young, vol. 27, no. 2, 2017, pp. 267-272.
Ehrlinspiel DM, Gass M, Balmer C. Transseptal puncture for radiofrequency catheter ablations of left-sided arrhythmias in a paediatric population. Cardiol Young. 2017;27(2):267-272.
Ehrlinspiel, D. M., Gass, M., & Balmer, C. (2017). Transseptal puncture for radiofrequency catheter ablations of left-sided arrhythmias in a paediatric population. Cardiology in the Young, 27(2), 267-272. https://doi.org/10.1017/S1047951116000457
Ehrlinspiel DM, Gass M, Balmer C. Transseptal Puncture for Radiofrequency Catheter Ablations of Left-sided Arrhythmias in a Paediatric Population. Cardiol Young. 2017;27(2):267-272. PubMed PMID: 27086493.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transseptal puncture for radiofrequency catheter ablations of left-sided arrhythmias in a paediatric population. AU - Ehrlinspiel,Désirée M, AU - Gass,Matthias, AU - Balmer,Christian, Y1 - 2016/04/18/ PY - 2016/4/19/pubmed PY - 2017/6/16/medline PY - 2016/4/19/entrez KW - Transseptal puncture KW - arrhythmia KW - complications KW - radiofrequency ablation KW - supraventricular tachycardia SP - 267 EP - 272 JF - Cardiology in the young JO - Cardiol Young VL - 27 IS - 2 N2 - Puncturing the atrial septum is frequently used in adults. In children, the transseptal puncture is less common, technically more demanding, and the rate of complications is not well described. We studied the feasibility and safety of this procedure in a retrospective analysis of 157 consecutive children undergoing transseptal puncture for radiofrequency catheter ablation of left atrial targets in two tertiary-care centres between 2005 and 2013. The median age of the patients at intervention was 12.5 years (1.1-18 years), with median weight of 42 kg (range 9.0-97.0 kg). Pre-excitation was found in 102 procedures, accessory pathway with exclusively retrograde conduction in 41, focal atrial tachycardia in nine, left-sided permanent junctional/reciprocating tachycardia-like accessory pathways in three, and atypical atrioventricular nodal re-entry tachycardia in two. All the procedures were guided by fluoroscopy. Additional imaging by transoesophageal echocardiography was used in three patients. Successful transseptal puncture was possible in 99.4% of the cases, ablation in 97.4%. The median time, including mapping and radiofrequency ablation, was 120 minutes (range 60-450), the median fluoroscopy time 10.8 minutes (range 1.8-75), and the median radiation dose 3 Gy cm2 (range 0.3-35). In total, five patients (3.2%) had a recurrent arrhythmia during the observation period of a median of 40 months (range 1-103). No complications associated with the transseptal puncture were observed. Transseptal puncture is a feasible and safe procedure in children. This access allows successful and efficient radiofrequency ablation of arrhythmia of the left atrium in the vast majority of the patients and might be considered as the first-line approach in this population. SN - 1467-1107 UR - https://www.unboundmedicine.com/medline/citation/27086493/Transseptal_puncture_for_radiofrequency_catheter_ablations_of_left_sided_arrhythmias_in_a_paediatric_population_ L2 - https://www.cambridge.org/core/product/identifier/S1047951116000457/type/journal_article DB - PRIME DP - Unbound Medicine ER -