147 Focal patterns of activation during atrial tachycardia in patients with surgically corrected congenital heart disease

Abstract

Results: a total of 145 patients were included. Median age was 15.3 (12.3, 17.1) years, 65 (45%) were male. Five patients (3%) had congenital heart disease. Arrhythmias treated were: Wolf-Parkinson-White (WPW) syndrome including variants of preexcitation (N=52), AV reentry tachycardias caused by retrograde conducting (concealed) accessory pathways (N=40), AV-nodal reentry tachycardia (N=45), ectopic atrial tachycardia (N=4), atrial flutter (N=3), and ventricular tachycardia (N=I). RFA was successful in 138/145 patients (95%). In three patients RFA was not technically possible, in another four patients the risk of high grade AV block was considered too high. During a median follow-up of 27 (15, 41 ) months, recurrence occurred in 12/138 patients (8.7%), who underwent additionally one (N=10) or two (N=2) RFA procedures before successful ablation was achieved. Procedure time was 55 (35,90) minutes and fluoroscopy time was 8.4 (4.3, 18.8) minutes. X-Ray dosage was 400 (200, 1.200) cGycm 2. Number of RFA pulses were 4 (2, 9), number of RFA pulses >20 seconds were 2 (1, 7), total ablation time wasll8 (63, 304) seconds, and total energy was 4.136 (2.208, 10.264) Ws. One patient with a septal accessory pathway (0.7%) had complicating highgrade AV block and required pacemaker implantation. No other serious complications occurred. Conclusions: in an experienced center, RFA in children and adolescents is associated with a high success rate, a low exposure to radiation, a low risk of serious complications, and few recurrences.