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[Transcatheter radiofrequency ablation in supraventricular tachycardia in children: immediate results and mid-term follow-up].
G Ital Cardiol 1996; 26(1):31-40GI

Abstract

OBJECTIVES

The purpose of this study was to evaluate the efficacy and safety of radiofrequency ablation of supraventricular tachycardias due to a reentry circuit in a group of closely followed-up pediatric patients.

PATIENTS

Forty-six pediatric patients (mean age 12.6 years, range 3-18) underwent a total of 48 radiofrequency ablation procedures for reciprocating supraventricular tachycardia. Thirty-nine had an orthodromic reentry tachycardia, 6 an atrioventricular node reentry tachycardia and 1 a permanent junctional reciprocating tachycardia.

METHODS

To ablate the overt accessory pathways, the Kent potential (K) was identified and then the shortest A-K, and delta wave-K intervals were measured. The shortest V-A interval was identified for those concealed. For the left-sided accessory pathways, we used the retrograde transaortic approach in 10 procedures and the transseptal approach in 18. Atrioventricular node reentry tachycardia was ablated at the site where the slow-pathway electrogram was recorded. Follow-up clinical data, electrocardiogram, 24-hours Holter monitoring and transesophageal atrial stimulation were obtained and evaluated.

RESULTS

Early: We performed a total of 48 procedures. Among 41 procedures performed in the 39 patients with accessory pathway, 38 were successful (92,6%). Mean fluoroscopy time was 31 +/- 18 min. For left sided accessory pathways, mean fluoroscopy time of procedures with retrograde approach was 45 +/- 10 min and with transseptal 23 +/- 12 min (p < 0.01). Ablation of slow-pathway in patients with intranodal reentry tachycardia was successful in 3/6 cases (50%). The patient with permanent junctional reciprocating tachycardia was successfully ablated. Late: All patients are alive and none was lost during the follow-up after a mean time of 12.9 months (range 5-33). Success at last follow-up was 100% in patients with an accessory pathway and 33% in patients with atrioventricular node reentry. In patient with permanent junctional reciprocating tachycardia, the arrhythmia appeared again one month after the procedure, thus a second successful attempt was performed.

COMPLICATIONS

Major complications (6,5%) including a right femoral vein thrombosis (one patient), an hematoma without pulse loss (one patient) and a non-sustained monomorphic ventricular tachycardia (one patient).

CONCLUSIONS

Our data show high efficacy of radiofrequency ablation in pediatric patients with accessory pathways. The risks are low at follow-up evaluation, but might be helpful a longer-term follow-up in order to evaluate the risk of a long fluoroscopy time and the arrhythmogenic effect of the scar.

Authors+Show Affiliations

Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

ita

PubMed ID

8682257

Citation

Montenero, A S., et al. "[Transcatheter Radiofrequency Ablation in Supraventricular Tachycardia in Children: Immediate Results and Mid-term Follow-up]." Giornale Italiano Di Cardiologia, vol. 26, no. 1, 1996, pp. 31-40.
Montenero AS, Drago F, Crea F, et al. [Transcatheter radiofrequency ablation in supraventricular tachycardia in children: immediate results and mid-term follow-up]. G Ital Cardiol. 1996;26(1):31-40.
Montenero, A. S., Drago, F., Crea, F., Varano, C., Guarneri, S., Cipriani, A., ... Zecchi, P. (1996). [Transcatheter radiofrequency ablation in supraventricular tachycardia in children: immediate results and mid-term follow-up]. Giornale Italiano Di Cardiologia, 26(1), pp. 31-40.
Montenero AS, et al. [Transcatheter Radiofrequency Ablation in Supraventricular Tachycardia in Children: Immediate Results and Mid-term Follow-up]. G Ital Cardiol. 1996;26(1):31-40. PubMed PMID: 8682257.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Transcatheter radiofrequency ablation in supraventricular tachycardia in children: immediate results and mid-term follow-up]. AU - Montenero,A S, AU - Drago,F, AU - Crea,F, AU - Varano,C, AU - Guarneri,S, AU - Cipriani,A, AU - Pelargonio,G, AU - Agostino,D A, AU - Bellocci,F, AU - Ragonese,P, AU - Zecchi,P, PY - 1996/1/1/pubmed PY - 1996/1/1/medline PY - 1996/1/1/entrez SP - 31 EP - 40 JF - Giornale italiano di cardiologia JO - G Ital Cardiol VL - 26 IS - 1 N2 - OBJECTIVES: The purpose of this study was to evaluate the efficacy and safety of radiofrequency ablation of supraventricular tachycardias due to a reentry circuit in a group of closely followed-up pediatric patients. PATIENTS: Forty-six pediatric patients (mean age 12.6 years, range 3-18) underwent a total of 48 radiofrequency ablation procedures for reciprocating supraventricular tachycardia. Thirty-nine had an orthodromic reentry tachycardia, 6 an atrioventricular node reentry tachycardia and 1 a permanent junctional reciprocating tachycardia. METHODS: To ablate the overt accessory pathways, the Kent potential (K) was identified and then the shortest A-K, and delta wave-K intervals were measured. The shortest V-A interval was identified for those concealed. For the left-sided accessory pathways, we used the retrograde transaortic approach in 10 procedures and the transseptal approach in 18. Atrioventricular node reentry tachycardia was ablated at the site where the slow-pathway electrogram was recorded. Follow-up clinical data, electrocardiogram, 24-hours Holter monitoring and transesophageal atrial stimulation were obtained and evaluated. RESULTS: Early: We performed a total of 48 procedures. Among 41 procedures performed in the 39 patients with accessory pathway, 38 were successful (92,6%). Mean fluoroscopy time was 31 +/- 18 min. For left sided accessory pathways, mean fluoroscopy time of procedures with retrograde approach was 45 +/- 10 min and with transseptal 23 +/- 12 min (p < 0.01). Ablation of slow-pathway in patients with intranodal reentry tachycardia was successful in 3/6 cases (50%). The patient with permanent junctional reciprocating tachycardia was successfully ablated. Late: All patients are alive and none was lost during the follow-up after a mean time of 12.9 months (range 5-33). Success at last follow-up was 100% in patients with an accessory pathway and 33% in patients with atrioventricular node reentry. In patient with permanent junctional reciprocating tachycardia, the arrhythmia appeared again one month after the procedure, thus a second successful attempt was performed. COMPLICATIONS: Major complications (6,5%) including a right femoral vein thrombosis (one patient), an hematoma without pulse loss (one patient) and a non-sustained monomorphic ventricular tachycardia (one patient). CONCLUSIONS: Our data show high efficacy of radiofrequency ablation in pediatric patients with accessory pathways. The risks are low at follow-up evaluation, but might be helpful a longer-term follow-up in order to evaluate the risk of a long fluoroscopy time and the arrhythmogenic effect of the scar. SN - 0046-5968 UR - https://www.unboundmedicine.com/medline/citation/8682257/[Transcatheter_radiofrequency_ablation_in_supraventricular_tachycardia_in_children:_immediate_results_and_mid_term_follow_up]_ DB - PRIME DP - Unbound Medicine ER -