Korean J Pediatr.  2017 Dec;60(12):390-394. 10.3345/kjp.2017.60.12.390.

Radiofrequency catheter ablation of atrioventricular nodal reentry tachycardia in children and adolescents: a single center experience

• Hyun MC

• KMID: 2398887
• DOI: http://doi.org/10.3345/kjp.2017.60.12.390

Abstract

PURPOSE
Atrioventricular nodal reentry tachycardia (AVNRT) is less common in pediatric patients than in adult patients. Thus, data for pediatric AVNRT patients are insufficient. Hence, we aimed to analyze the patient characteristics, treatment, and any recurrences in pediatric AVNRT patients.
METHODS
We reviewed the records of 50 pediatric AVNRT patients who had undergone radiofrequency catheter ablation (RFCA) between January 1998 and December 2016 at a single regional center. The patients were aged ≤18 years.
RESULTS
Among 190 pediatric patients who underwent RFCA for tachyarrhythmia, 50 (26.3%; mean age, 13.4±2.6 years) were diagnosed as having AVNRT by electrophysiological study. Twenty-five patients (25 of 50, 50%) were male. Twenty patients (20 of 50, 40%) used beta-blockers before RFCA. All patients had no structural heart disease except 1 patient with valvular aortic stenosis and coarctation of the aorta. RFCA was performed using the anatomic approach under fluoroscopic guidance. The most common successfully ablated region was the midseptal region (25 of 50, 50%). Slow pathway (SP) ablation and SP modulation were performed in 43 and 6 patients, respectively. Complication occurred in 1 patient with complete atrioventricular block. During follow-up, 6 patients had recurrence of supraventricular tachycardia, as confirmed by electrocardiography. Among them, 5 underwent successful ablation at the first procedure. In 1 patient, induction failed during the first procedure.
CONCLUSION
RFCA is safe and effective in pediatric AVNRT patients. However, further research is needed for establishing the endpoints of ablation in pediatric AVNRT patients and for identifying risk factors by evaluating data on AVNRT recurrence after RFCA.

Keyword

Atrioventricular nodal reentry tachycardia; Ablation; Child; Adolescents; Recurrence

MeSH Terms

Adolescent*
Adult
Aortic Coarctation
Aortic Valve Stenosis
Atrioventricular Block
Catheter Ablation*
Child*
Electrocardiography
Follow-Up Studies
Heart Diseases
Humans
Male
Recurrence
Risk Factors
Tachycardia
Tachycardia, Atrioventricular Nodal Reentry*
Tachycardia, Supraventricular