open access

Ahead of print
Original articles
Published online: 2017-08-21
Submitted: 2017-04-05
Accepted: 2017-07-06
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Initial experience of catheter ablation for cardiac arrhythmias in children and adolescents at a newly built ablation centre

Radosław Pietrzak, Piotr Lodziński, Tomasz Książczyk, Paweł Balsam, Monika Gawałko, Grzegorz Opolski, Bożena Werner
DOI: 10.5603/KP.a2017.0166

open access

Ahead of print
Original articles
Published online: 2017-08-21
Submitted: 2017-04-05
Accepted: 2017-07-06

Abstract

Background: Catheter ablation (CA) therapy is the first choice treatment in adults with heart rhythm disturbances. The arrhythmias in adults are mainly conditioned by coronary disease.  Etiology of arrhythmias in children is mostly associated with inherited heart disorders.  According to the current guidelines the CA is widely used in children, indicating the need to make it more achievable in pediatric population. 

Aim: To assess efficacy and safety of CA in children with different types of arrhythmias on the initial learning curve at newly built Ablation Center in The Independent Pediatric Hospital of Medical University of Warsaw.

Methods: The study population consisted of 32 children with supraventricular tachycardias, asymptomatic pre-excitation syndrome or ventricular ectopic beats undergoing CA. The mean age of study population was 14.1±2.4 years. In all patients, electrophysiological study (EPS) and CA was performed. Analysis with respect to procedure duration, fluoroscopy exposure duration, location of accessory pathways (AP), success rate, recurrences and complications was performed.

Results: The mean procedure duration was 105.4±41.4 minutes (range 40-175 minutes). The mean fluoroscopy duration was 8:34±5:01 minutes (range 1:28-21:01). The mean exposure to ionizing radiation was 4.7±3.2 mcG/kg. EPS revealed significantly more frequent presence of AP in the left side (57.1%). The RF ablation procedure was successful in 26 of 32 (81.3%) children and cryoablation was successful in 2 of 4 patients. In two children (6.3%) minor complications occurred.

Conclusions: Catheter ablation may be effectively performed without major complications in the initial phase of the learning curve if a reasonable approach with a gradual increase of the procedural complexity is taken

Abstract

Background: Catheter ablation (CA) therapy is the first choice treatment in adults with heart rhythm disturbances. The arrhythmias in adults are mainly conditioned by coronary disease.  Etiology of arrhythmias in children is mostly associated with inherited heart disorders.  According to the current guidelines the CA is widely used in children, indicating the need to make it more achievable in pediatric population. 

Aim: To assess efficacy and safety of CA in children with different types of arrhythmias on the initial learning curve at newly built Ablation Center in The Independent Pediatric Hospital of Medical University of Warsaw.

Methods: The study population consisted of 32 children with supraventricular tachycardias, asymptomatic pre-excitation syndrome or ventricular ectopic beats undergoing CA. The mean age of study population was 14.1±2.4 years. In all patients, electrophysiological study (EPS) and CA was performed. Analysis with respect to procedure duration, fluoroscopy exposure duration, location of accessory pathways (AP), success rate, recurrences and complications was performed.

Results: The mean procedure duration was 105.4±41.4 minutes (range 40-175 minutes). The mean fluoroscopy duration was 8:34±5:01 minutes (range 1:28-21:01). The mean exposure to ionizing radiation was 4.7±3.2 mcG/kg. EPS revealed significantly more frequent presence of AP in the left side (57.1%). The RF ablation procedure was successful in 26 of 32 (81.3%) children and cryoablation was successful in 2 of 4 patients. In two children (6.3%) minor complications occurred.

Conclusions: Catheter ablation may be effectively performed without major complications in the initial phase of the learning curve if a reasonable approach with a gradual increase of the procedural complexity is taken

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Keywords

catheter ablation, electrophysiological study, supraventricular tachycardia, preexcitation syndrome, children

About this article
Title

Initial experience of catheter ablation for cardiac arrhythmias in children and adolescents at a newly built ablation centre

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Ahead of print

Published online

2017-08-21

DOI

10.5603/KP.a2017.0166

Keywords

catheter ablation
electrophysiological study
supraventricular tachycardia
preexcitation syndrome
children

Authors

Radosław Pietrzak
Piotr Lodziński
Tomasz Książczyk
Paweł Balsam
Monika Gawałko
Grzegorz Opolski
Bożena Werner

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