Abstract
An increasing number of children are undergoing radiofrequency catheter ablation (RFCA) for tachyarrhythmia. However, infants and toddlers undergoing RFCA are often resistant to medication or need to eliminate arrhythmia substrate, and the risks of RFCA complications are still high in infants and toddlers. From April 2008 and December 2016, 285 children who underwent radiofrequency catheter ablation (RFCA) were stratified according to body weight (group A, less than 10 kg, n = 22; group B, over 10 kg, n = 263) and the clinical features of RFCA were retrospectively reviewed in these groups. Indications for RFCA included drug-refractory tachyarrhythmia or symptomatic tachycardia and tachycardia-induced cardiomyopathy. The acute success rate in this group was 90.9%, with a relatively low recurrence rate (15.0%) after 7.0 ± 1.6 years follow-up. We performed RFCA using only 2–4 catheters in all cases. Major complications included complete right bundle branch block in one patient. No significant differences in rates of success, recurrence, or complications were noted between children weighing less and more than 10 kg. RFCA is safe and efficacious for tachyarrhythmia even in patients weighing less than 10 kg.
Highlights
Radiofrequency catheter ablation (RFCA) is the standard treatment for tachyarrhythmia in school-aged children [1, 2], and this procedure has recently been shown to be safe and effective for application in infants and toddlers as well [3, 4]
Three patients had heterotaxy syndrome with right atrial isomerism and complex congenital heart disease
The main findings of this retrospective study of radiofrequency catheter ablation (RFCA) in small children weighing less than 10 kg are as follows: (1) The acute success rate in group A was 90.9%. (2) The total number of catheters used during the RFCA procedure was less in group A than group B, and (3) the rates of success, recurrence, and complications did not differ significantly between patients weighing less and more than 10 kg
Summary
Radiofrequency catheter ablation (RFCA) is the standard treatment for tachyarrhythmia in school-aged children [1, 2], and this procedure has recently been shown to be safe and effective for application in infants and toddlers as well [3, 4]. RFCA is being increasingly performed for children with tachyarrhythmia. Irrespective of whether they have congenital heart disease or not, infants and toddlers undergoing ablation are often resistant to medication or need substrate elimination for tachyarrhythmia. In patients weighing less than 10 kg, the caliber of approaching vessels is relatively small, so the number of usable catheters is limited. With advances in technology and greater experience with RFCA, the challenges of RFCA in patients less than 10 kg have been gradually overcome
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