Clinical outcomes of children with normal cardiac anatomy having radiofrequency catheter ablation ≥10 years earlier

Abstract

requires a premature depolarization for initiation. 3,5 Gender differences in 1 of these factors could explain why females may begin experiencing accessory pathway-mediated tachycardias at a younger age than males. Alternatively, it may be possible that the apparently younger age of tachycardia onset in women is due to a gender difference in the ability to accurately recall a remote episode of tachycardia, or to a heightened perception of tachycardia-related symptoms in women. A finding of this study is that accessory pathwaymediated tachycardias utilizing a right-sided accessory pathway may begin to occur a mean of 3 years earlier than when the accessory pathway is left-sided. The reason for this difference in age of tachycardia onset between right- and left-sided accessory pathways is unclear. The induction of orthodromic atrioventricular reentry is facilitated by atrial premature depolarizations that arise close to the atrial insertion of the accessory pathway. 5 Therefore, if premature atrial depolarizations were more likely to arise in the right atrium than in the left atrium, this might explain the earlier onset of tachycardias utilizing right-sided accessory pathways. However, the actual explanation for the difference in age of tachycardia onset depending on accessory pathway location remains conjectural at this time. A limitation of this study is that the age of onset of symptomatic tachycardia was determined by patient interviews, with objective verification not being possible. The data therefore may have been subject to errors introduced by inaccurate reporting by patients. In conclusion, there are interactions among gender, accessory pathway location, and the age of onset of accessory pathway-mediated tachycardia. The age of onset of accessory pathway-mediated tachycardia is influenced by gender and by the accessory pathway location, but not by whether the accessory pathway is concealed or manifest.