Irrigated Radiofrequency Catheter Ablation with Limited Fluoroscopy for Ventricular Arrhythmias in Children and Adolescents

Ventricular Arrhythmia Ablation in Children

Abstract

Background: There are insufficient studies regarding the use of irrigated catheters for ventricular arrhythmia ablations in pediatric patients; therefore, most of the information on this subject has been obtained from studies conducted with adults.
Objective: This study aimed to assess the outcomes of irrigated catheter ablations performed using limited or zero fluoroscopy with the guidance of a three-dimensional electroanatomic mapping system in a pediatric ventricular arrhythmia patient group.
Methods: Thirty-nine consecutive pediatric patients undergoing irrigated catheter ventricular arrhythmia ablations at a single tertiary center were enrolled in this study. All of the children underwent electrophysiological studies using EnSite NavX system guidance with limited or zero fluoroscopy. The ventricular arrhythmia ablations were performed using irrigated catheters in all of the patients.
Results: The mean age of the patients was 12 years old (range = 3.5–17 years) and the mean weight was 50 kg (range = 12–84 kg). The mean procedure time was 165 ± 53 minutes. No fluoroscopy was used in most of the patients (30/39, 77%), and acute success was achieved in 35 patients (89.7%). During a mean follow-up period of 26.7 ± 13.7 months, ventricular arrhythmias recurred in nine patients. Four of these patients underwent successful ablations again and remaining five were followed-up with medical therapy without problems. No complications were seen.
Conclusion: Ventricular arrhythmia ablations can be performed safely and effectively using irrigated catheters in pediatric patients. In addition, successful radiofrequency ablations can be achieved using three-dimensional electroanatomic mapping system without fluoroscopy in most patients.