Radiofrequency catheter ablation of tachycardia in children with and without congenital heart disease

Indications and limitations

Mei Hwan Wu, Jiunn Li Lin, Lin Pin Lai, Ming Lon Young, Chun Wei Lu, Yung Ching Chang, Jou Kou Wang, Hung Chi Lue

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

From 1993 to 1998, a total of 100 consecutive pediatric patients with tachycardia (45 male and 55 female, aged 1 year 10 months to 17 years, 11±4 year) who underwent electrophysiological study were reviewed. Eleven of them were younger than 5 years. Two had tachycardia-related cerebrovascular accident. Congenital heart disease was found in 12 patients. After propofol anesthesia, the clinical tachycardia could not be induced in three (two atrial tachycardia and one AV nodal re-entrant tachycardia) and became nonsustained in five (atrial tachycardia). Mechanical ablation occurred in three and two had subsequent recurrences. Among the 85 cases who received radiofrequency ablation, the overall final success rate of RF ablation for all diagnoses was 94% with a diagnosis-specific success rate ranging from 100 to 57%. Tachycardia cardiomyopathy was noted in four (three atrial tachycardia and one junctional ectopic tachycardia) and all regressed after successful ablation. Success in two patients with left posterioseptal accessory pathway could only be achieved by delivering the energy at the middle cardiac vein. Two patients with right atrial isomerism had an 'AV nodal-to-AV nodal tachycardia' which was eliminated by ablation. Total recurrence rate was 13% but final success was achieved in all during re-study except the three patients who refused re-intervention. The atrial tachycardia developed in postoperative congenital heart disease was associated with the lowest success rate (57%) and highest recurrence rate (25%). Procedure-related complications occurred in four; two with transient brachial palsy, one with first-degree AV block and one with blood loss requiring blood transfusion. In conclusion, the experience of this single center confirmed the efficacy and safety of radiofrequency catheter ablation in treating pediatric arrhythmias, but the limitations in postoperative arrhythmias and the effects of propofol on tachycardia induction (especially the atrial tachycardia) need to be improved.

Original languageEnglish
Pages (from-to)221-227
Number of pages7
JournalInternational Journal of Cardiology
Volume72
Issue number3
DOIs
Publication statusPublished - Feb 15 2000
Externally publishedYes

Fingerprint

Catheter Ablation
Tachycardia
Heart Diseases
Propofol
Recurrence
Cardiac Arrhythmias
Ectopic Junctional Tachycardia
Heterotaxy Syndrome
Pediatrics
Atrioventricular Block
Patient Rights
Cardiomyopathies
Paralysis
Blood Transfusion
Veins
Arm
Anesthesia
Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Radiofrequency catheter ablation of tachycardia in children with and without congenital heart disease : Indications and limitations. / Wu, Mei Hwan; Lin, Jiunn Li; Lai, Lin Pin; Young, Ming Lon; Lu, Chun Wei; Chang, Yung Ching; Wang, Jou Kou; Lue, Hung Chi.

In: International Journal of Cardiology, Vol. 72, No. 3, 15.02.2000, p. 221-227.

Research output: Contribution to journalArticle

Wu, Mei Hwan ; Lin, Jiunn Li ; Lai, Lin Pin ; Young, Ming Lon ; Lu, Chun Wei ; Chang, Yung Ching ; Wang, Jou Kou ; Lue, Hung Chi. / Radiofrequency catheter ablation of tachycardia in children with and without congenital heart disease : Indications and limitations. In: International Journal of Cardiology. 2000 ; Vol. 72, No. 3. pp. 221-227.
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AU - Lue, Hung Chi

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