Tags

Type your tag names separated by a space and hit enter

Follow-up of radiofrequency catheter ablation in children: results in 100 consecutive patients.
J Am Coll Cardiol 1994; 23(7):1651-9JACC

Abstract

OBJECTIVES

The purpose of this study was to determine the outcome of a group of closely followed-up pediatric patients who had undergone radiofrequency ablation for cardiac arrhythmias.

BACKGROUND

Although radiofrequency ablation in children has been shown to be effective and safe in the short term, results of longer term follow-up of these children must be considered when determining the place of radiofrequency ablation in the management of pediatric arrhythmias.

METHODS

One hundred children aged 2 months to 17 years underwent a total of 119 radiofrequency ablation procedures for cure of tachycardia. Follow-up clinical data, electrocardiograms and 24-h Holter monitors were obtained and analyzed.

RESULTS

All patients were alive, and none were lost to follow-up after a mean follow-up of 21.5 months (range 6 to 50). Success at last follow-up included accessory pathways in 66 (89%) of 74 patients, atrioventricular (AV) node reentry in 15 (88%) of 17, intraatrial reentry in 2 (67%) of 3, atrial flutter in 3 (100%) of 3, atrial ectopic tachycardia in 2 (67%) of 3, junctional ectopic tachycardia in 1 (100%) of 1 and ventricular tachycardia in 2 (100%) of 2 (overall success, 90 [90%] of 100). All recurrences were observed within 6 months of ablation. Major and minor complications (7%) included chest burn (one patient), foot microembolus (two patients), hematoma without pulse loss (four patients), femoral arteriovenous fistula requiring repair (one patient) and transient Mobitz I AV block (one patient). Immediate success, recurrence and complication rates were similar in the > or = 12-year old versus the < 12-year old group. Echocardiograms, available in 109 (92%) of 119 patients, showed possible procedure-related abnormalities in 2 (mitral regurgitation in 1, tricuspid regurgitation in 1, both mild), with no aortic insufficiency after 30 left-sided ablations performed by the retrograde approach. Follow-up Holter monitors, available in 77 (77%) of 100 patients, showed possible procedure-related abnormalities in 5 (frequent atrial ectopic tachycardia in 2, atrial flutter in 1, accelerated ventricular rhythm in 2). There were no early or late deaths.

CONCLUSIONS

In children, the risks of radiofrequency ablation are low at follow-up evaluation. Longer-term follow-up of children undergoing radiofrequency ablation will be necessary to determine whether coronary abnormalities or serious new arrhythmias will develop.

Authors+Show Affiliations

Department of Pediatrics, University of California San Francisco School of Medicine.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8195527

Citation

Van Hare, G F., et al. "Follow-up of Radiofrequency Catheter Ablation in Children: Results in 100 Consecutive Patients." Journal of the American College of Cardiology, vol. 23, no. 7, 1994, pp. 1651-9.
Van Hare GF, Witherell CL, Lesh MD. Follow-up of radiofrequency catheter ablation in children: results in 100 consecutive patients. J Am Coll Cardiol. 1994;23(7):1651-9.
Van Hare, G. F., Witherell, C. L., & Lesh, M. D. (1994). Follow-up of radiofrequency catheter ablation in children: results in 100 consecutive patients. Journal of the American College of Cardiology, 23(7), pp. 1651-9.
Van Hare GF, Witherell CL, Lesh MD. Follow-up of Radiofrequency Catheter Ablation in Children: Results in 100 Consecutive Patients. J Am Coll Cardiol. 1994;23(7):1651-9. PubMed PMID: 8195527.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Follow-up of radiofrequency catheter ablation in children: results in 100 consecutive patients. AU - Van Hare,G F, AU - Witherell,C L, AU - Lesh,M D, PY - 1994/6/1/pubmed PY - 1994/6/1/medline PY - 1994/6/1/entrez SP - 1651 EP - 9 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 23 IS - 7 N2 - OBJECTIVES: The purpose of this study was to determine the outcome of a group of closely followed-up pediatric patients who had undergone radiofrequency ablation for cardiac arrhythmias. BACKGROUND: Although radiofrequency ablation in children has been shown to be effective and safe in the short term, results of longer term follow-up of these children must be considered when determining the place of radiofrequency ablation in the management of pediatric arrhythmias. METHODS: One hundred children aged 2 months to 17 years underwent a total of 119 radiofrequency ablation procedures for cure of tachycardia. Follow-up clinical data, electrocardiograms and 24-h Holter monitors were obtained and analyzed. RESULTS: All patients were alive, and none were lost to follow-up after a mean follow-up of 21.5 months (range 6 to 50). Success at last follow-up included accessory pathways in 66 (89%) of 74 patients, atrioventricular (AV) node reentry in 15 (88%) of 17, intraatrial reentry in 2 (67%) of 3, atrial flutter in 3 (100%) of 3, atrial ectopic tachycardia in 2 (67%) of 3, junctional ectopic tachycardia in 1 (100%) of 1 and ventricular tachycardia in 2 (100%) of 2 (overall success, 90 [90%] of 100). All recurrences were observed within 6 months of ablation. Major and minor complications (7%) included chest burn (one patient), foot microembolus (two patients), hematoma without pulse loss (four patients), femoral arteriovenous fistula requiring repair (one patient) and transient Mobitz I AV block (one patient). Immediate success, recurrence and complication rates were similar in the > or = 12-year old versus the < 12-year old group. Echocardiograms, available in 109 (92%) of 119 patients, showed possible procedure-related abnormalities in 2 (mitral regurgitation in 1, tricuspid regurgitation in 1, both mild), with no aortic insufficiency after 30 left-sided ablations performed by the retrograde approach. Follow-up Holter monitors, available in 77 (77%) of 100 patients, showed possible procedure-related abnormalities in 5 (frequent atrial ectopic tachycardia in 2, atrial flutter in 1, accelerated ventricular rhythm in 2). There were no early or late deaths. CONCLUSIONS: In children, the risks of radiofrequency ablation are low at follow-up evaluation. Longer-term follow-up of children undergoing radiofrequency ablation will be necessary to determine whether coronary abnormalities or serious new arrhythmias will develop. SN - 0735-1097 UR - https://www.unboundmedicine.com/medline/citation/8195527/Follow_up_of_radiofrequency_catheter_ablation_in_children:_results_in_100_consecutive_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0735-1097(94)90670-X DB - PRIME DP - Unbound Medicine ER -