Abstract
OBJECTIVES. The purpose of this study was to evaluate the efficacy and safety of radiofrequency ablation of supraventricular tachycardias due to a reentry circuit in a group of closely followed-up pediatric patients. PATIENTS. Forty-six pediatric patients (mean age 12.6 years, range 3-18 ) underwent a total of 48 radiofrequency ablation procedures for reciprocating supraventricular tachycardia. Thirty-nine had an orthodromic reentry tachycardia, 6 an atrioventricular node reentry tachycardia and 1 a permanent junctional reciprocating tachycardia. METHODS. To ablate the overt accessory pathways, the Kent potential (K) was identified and then the shortest A-K, and delta wave-K intervals were measured. The shortest V-A interval was identified for those concealed. For the left-sided accessory pathways, we used the retrograde transaortic approach in 10 procedures and the transeptal approach in 18. Atrioventricular node reentry tachycardia was ablated at the site where the slow-pathway electrogram was recorded. Follow-up clinical data, electrocardiogram, 24-hours Holter monitoring and transesophageal atrial stimulation were obtained and evaluated. RESULTS. Early: We performed a total of 48 procedures. Among 41 procedures performed in the 39 patients with accessory pathway, 38 were successful (92,6%). Mean fluoroscopy time was 31 ± 18 min. For left sided accessory pathways, mean fluoroscopy time of procedures with retrograde approach was 45 ± 10 min and with transeptal 23 ± 12 min (p <0.01). Ablation of slow-pathway in patients with intranodal reentry tachycardia was successful in 3/6 cases (50%). The patient with permanent junctional reciprocating tachycardia was successfully ablated. Late: All patients are alive and none was lost during the follow-up after a mean time of 12.9 months (range 5-33). Success at last follow-up was 100% in patients with an accessory pathway and 33% in patients with atrioventricular node reentry. In patient with permanent junctional reciprocating tachycardia, the arrhythmia appeared again one month after the procedure, thus a second successful attempt was performed. Complications: Major complications (6,5%) including a right femoral vein thrombosis (one patient), an hematoma without pulse loss (one patient) and a non-sustained monomorphic ventricular tachycardia (one patient). CONCLUSIONS. Our data show high efficacy of radiofrequency ablation in pediatric patients with accessory pathways. The risks are low at follow-up evaluation, but might be helpful a longer-term follow-up in order to evaluate the risk of a long fluoroscopy time and the arrhythmogenic effect of the scar.
| Original language | Italian |
|---|---|
| Pages (from-to) | 31-40 |
| Number of pages | 10 |
| Journal | Giornale Italiano di Cardiologia |
| Volume | 26 |
| Issue number | 1 |
| Publication status | Published - Jan 1996 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
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Ablazione transcatetere con radiofrequenza delle tachicardie sopraventricolari in età pediatrica : Risultati immediati e di un follow-up a medio termine. / Montenero, Annibale Sandro; Drago, Fabrizio; Crea, Filippo; Varano, Carmelita; Guarneri, Sergio; Cipriani, Adriano; Pelargonio, Gemma; Agostino, Domenico Antonio; Bellocci, Fulvio; Ragonese, Pietro; Zecchi, Paolo.
In: Giornale Italiano di Cardiologia, Vol. 26, No. 1, 01.1996, p. 31-40.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Ablazione transcatetere con radiofrequenza delle tachicardie sopraventricolari in età pediatrica
T2 - Risultati immediati e di un follow-up a medio termine
AU - Montenero, Annibale Sandro
AU - Drago, Fabrizio
AU - Crea, Filippo
AU - Varano, Carmelita
AU - Guarneri, Sergio
AU - Cipriani, Adriano
AU - Pelargonio, Gemma
AU - Agostino, Domenico Antonio
AU - Bellocci, Fulvio
AU - Ragonese, Pietro
AU - Zecchi, Paolo
PY - 1996/1
Y1 - 1996/1
N2 - OBJECTIVES. The purpose of this study was to evaluate the efficacy and safety of radiofrequency ablation of supraventricular tachycardias due to a reentry circuit in a group of closely followed-up pediatric patients. PATIENTS. Forty-six pediatric patients (mean age 12.6 years, range 3-18 ) underwent a total of 48 radiofrequency ablation procedures for reciprocating supraventricular tachycardia. Thirty-nine had an orthodromic reentry tachycardia, 6 an atrioventricular node reentry tachycardia and 1 a permanent junctional reciprocating tachycardia. METHODS. To ablate the overt accessory pathways, the Kent potential (K) was identified and then the shortest A-K, and delta wave-K intervals were measured. The shortest V-A interval was identified for those concealed. For the left-sided accessory pathways, we used the retrograde transaortic approach in 10 procedures and the transeptal approach in 18. Atrioventricular node reentry tachycardia was ablated at the site where the slow-pathway electrogram was recorded. Follow-up clinical data, electrocardiogram, 24-hours Holter monitoring and transesophageal atrial stimulation were obtained and evaluated. RESULTS. Early: We performed a total of 48 procedures. Among 41 procedures performed in the 39 patients with accessory pathway, 38 were successful (92,6%). Mean fluoroscopy time was 31 ± 18 min. For left sided accessory pathways, mean fluoroscopy time of procedures with retrograde approach was 45 ± 10 min and with transeptal 23 ± 12 min (p <0.01). Ablation of slow-pathway in patients with intranodal reentry tachycardia was successful in 3/6 cases (50%). The patient with permanent junctional reciprocating tachycardia was successfully ablated. Late: All patients are alive and none was lost during the follow-up after a mean time of 12.9 months (range 5-33). Success at last follow-up was 100% in patients with an accessory pathway and 33% in patients with atrioventricular node reentry. In patient with permanent junctional reciprocating tachycardia, the arrhythmia appeared again one month after the procedure, thus a second successful attempt was performed. Complications: Major complications (6,5%) including a right femoral vein thrombosis (one patient), an hematoma without pulse loss (one patient) and a non-sustained monomorphic ventricular tachycardia (one patient). CONCLUSIONS. Our data show high efficacy of radiofrequency ablation in pediatric patients with accessory pathways. The risks are low at follow-up evaluation, but might be helpful a longer-term follow-up in order to evaluate the risk of a long fluoroscopy time and the arrhythmogenic effect of the scar.
AB - OBJECTIVES. The purpose of this study was to evaluate the efficacy and safety of radiofrequency ablation of supraventricular tachycardias due to a reentry circuit in a group of closely followed-up pediatric patients. PATIENTS. Forty-six pediatric patients (mean age 12.6 years, range 3-18 ) underwent a total of 48 radiofrequency ablation procedures for reciprocating supraventricular tachycardia. Thirty-nine had an orthodromic reentry tachycardia, 6 an atrioventricular node reentry tachycardia and 1 a permanent junctional reciprocating tachycardia. METHODS. To ablate the overt accessory pathways, the Kent potential (K) was identified and then the shortest A-K, and delta wave-K intervals were measured. The shortest V-A interval was identified for those concealed. For the left-sided accessory pathways, we used the retrograde transaortic approach in 10 procedures and the transeptal approach in 18. Atrioventricular node reentry tachycardia was ablated at the site where the slow-pathway electrogram was recorded. Follow-up clinical data, electrocardiogram, 24-hours Holter monitoring and transesophageal atrial stimulation were obtained and evaluated. RESULTS. Early: We performed a total of 48 procedures. Among 41 procedures performed in the 39 patients with accessory pathway, 38 were successful (92,6%). Mean fluoroscopy time was 31 ± 18 min. For left sided accessory pathways, mean fluoroscopy time of procedures with retrograde approach was 45 ± 10 min and with transeptal 23 ± 12 min (p <0.01). Ablation of slow-pathway in patients with intranodal reentry tachycardia was successful in 3/6 cases (50%). The patient with permanent junctional reciprocating tachycardia was successfully ablated. Late: All patients are alive and none was lost during the follow-up after a mean time of 12.9 months (range 5-33). Success at last follow-up was 100% in patients with an accessory pathway and 33% in patients with atrioventricular node reentry. In patient with permanent junctional reciprocating tachycardia, the arrhythmia appeared again one month after the procedure, thus a second successful attempt was performed. Complications: Major complications (6,5%) including a right femoral vein thrombosis (one patient), an hematoma without pulse loss (one patient) and a non-sustained monomorphic ventricular tachycardia (one patient). CONCLUSIONS. Our data show high efficacy of radiofrequency ablation in pediatric patients with accessory pathways. The risks are low at follow-up evaluation, but might be helpful a longer-term follow-up in order to evaluate the risk of a long fluoroscopy time and the arrhythmogenic effect of the scar.
KW - Ablation
KW - Children
KW - Radiofrequency
KW - Supraventricular tachycardia
UR - http://www.scopus.com/inward/record.url?scp=0029692476&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029692476&partnerID=8YFLogxK
M3 - Articolo
VL - 26
SP - 31
EP - 40
JO - Giornale Italiano di Cardiologia
JF - Giornale Italiano di Cardiologia
SN - 0046-5968
IS - 1
ER -