Serial Changes of CK, CK-MB after Radiofrequency Catheter Ablation in Pediatric Patients

Kim, Se Young; Hyun, Myung Chul

Abstract

PURPOSE
To investigate the degree of myocardial injury incurred by radiofrequency catheter ablation(RFCA), we serially measured CK, CK-MB levels in 24 pediatric paroxysmal supraventricular tachycardia patients undergoing RFCA(male : 12, female : 12, mean age : 10.5 years, mean weight : 37.2 kg).
METHODS
We serially measured blood CK, CK-MB levels, 1 day before RFCA(baseline), 8 hours after RFCA(stage 1), 16 hours after RFCA(stage 2), 24 hours after RFCA. Serial changes of CK, CK-MB levels were compared with baseline levels, age, body weight, number of applied RFCAs, total duration of RFCAs and the site of ablation(left heart ablation, right heart ablation).
RESULTS
Compared with baseline levels of CK, CK-MB, there were significant increases in CK and CK-MB levels in stage 1(base line : 130.7+/-54.0 U/L, 1.97+/-1.74 micro gram/L, stage 1 : 233.7+/-165.1, P=0.04, 7.71+/-7.96, P=0.01, stage 2 : 207.4+/-131.3, P=0.19, 6.51+/-8.54, P=0.08, stage 3 : 215.7+/-151.4, P=0.13, 5.09+/-4.38, P=0.36). The CK level was found to be elevated(>195 u/L) in 13 patients(54 %), while the CK-MB level was elevated(>5 micro gram/L) in 12 patients(50%). Comparing left heart ablations(n=11) and right heart ablations(n=13), CK-MB level in stage 1 was significantly increased in left heart ablation(12.29+/-9.79 micro gram/L, 3.82+/-2.48, P=0.02). In right heart ablations, there were significant correlations between the number of applied RFCAs and CK-MB level in stage 1(P=0.02, r=0.65).
CONCLUSION
Significant myocardial injury was incurred by RFCA. Considering the small growing heart of pediatric patients, we should take efforts to minimize myocardial injuries.