Int J Arrhythm.  2020 Dec;21(4):18. 10.1186/s42444-020-00026-4.

Radiofrequency catheter ablation of ventricular tachycardia in pediatric patients

• Park W
• Song M
• Kim G
• Lee S
• Kwon H
• Bae E

• KMID: 2511736
• DOI: http://doi.org/10.1186/s42444-020-00026-4

Abstract

Background
Radiofrequency catheter ablation (RFCA) has been accepted as an efficient therapy for tachycardia, and substantial improvement in the outcomes of RFCA in pediatric patients has been seen. However, there is not enough data on the clinical outcomes of RFCA for ventricular tachycardia (VT) in pediatric patients. The objective of this study was to elucidate the efficacy and safety of RFCA for VT in pediatric patients.
Methods
We performed a retrospective study involving 35 consecutive pediatric VT ablation procedures in 28 patients at a single institution.
Results
The median age at ablation was 14.0 years (range 6.9–19.2 years). There were 24 patients with a structurally normal heart and four patients with congenital heart disease (CHD). The left ventricular posteroseptal area was the most common site of VT origin (22/28, 78.6%). However, there was an unusual case of VT which involved a papillary muscle as its origin. Acute success was achieved in 30 (85.7%) of 35 procedures. The recurrence rate after successful RFCA was 14.2% (5/35) at a median follow-up of 6.7 years (range 1.0–16.7 years). There were five procedural failures due to the inability to induce VT for complete mapping. Ultimately, long-term success was achieved in 27 patients (96.4%) after repeated procedures and no major complications occurred. Long-term success was associated with VT inducibility (p = < 0.001).
Conclusions
Difficulty in inducing VT for precise mapping was a significant obstacle to successful RFCA. RFCA was identified as safe and effective therapy to eliminate VT in the selected pediatric VT patients.

Keyword

Ventricular tachycardia; Catheter ablation; Pediatrics; Inducibility; Mapping