RADIOFREQUENCY ABLATION FOR SUPRAVENTRICULAR AND VENTRICULAR-TACHYCARDIA IN YOUNG-PATIENTS

Radiofrequency ablation therapy was conducted in 86 consecutive childr en and young patients with a mean age of 14 +/- 3 years (range = 3-18) . Fifty-two patients had Wolff-Parkinson-White syndrome, one had re-en try tachycardia incorporating a nodoventricular fiber, 22 had atrioven tricular node re-entry tachycardia, two had atrial tachycardia and nin e had idiopathic ventricular tachycardia. Radiofrequency ablation was successful in 50 of the 52 patients (96%) with Wolff-Parkinson-White s yndrome and the one with nodoventricular fiber. Radiofrequency modific ation of the atrioventricular node using the inferior approach was suc cessful in eliminating atrioventricular node re-entry tachycardia in 2 0 of the 22 patients (91%). Radiofrequency ablation in the two patient s with atrial tachycardia was unsuccessful. Of the nine patients with idiopathic ventricular tachycardia, eight from the left ventricle and one from the right ventricular outflow tract, eight were successfully ablated (88%). Follow-up over a period ranging from 1 to 46 months (21 +/- 13) revealed a recurrence of tachycardia in seven patients; a lat e electrophysiological study in 38 patients revealed the induction of tachycardia in 11 patients (seven with accessory pathway-mediated tach ycardia, three with atrioventricular node re-entry tachycardia and one with idiopathic ventricular tachycardia). All 11 patients were succes sfully ablated by a second trial. In conclusion, radiofrequency ablati on therapy is effective and safe in pediatric patients with supraventn cular and ventricular tachycardia and should be considered as the ther apy of choice in this group of patients.