5-YEAR EXPERIENCE WITH RADIOFREQUENCY CATHETER ABLATION - IMPLICATIONS FOR MANAGEMENT OF ARRHYTHMIAS IN PEDIATRIC AND YOUNG-ADULT PATIENTS

Objective: A review of the results of the first 5 years of radiofreque ncy catheter ablation procedures performed at Children's Hospital, Bos ton, a large tertiary referral center for patients with congenital hea rt disease and arrhythmias common to the infant, child, and young adul t. Study design: A retrospective review of 410 consecutive procedures in 346 patients who underwent at least one application of radiofrequen cy energy for the treatment of recurrent supraventricular or ventricul ar tachycardia. Results: The overall final success rate for all diagno ses was 90%, with a higher success rate in patients with an accessory pathway (96%). During the 5-year study period, the success rate improv ed while the rates of failures and late recurrences declined. The inci dence of serious complications was 1.2% (1 late death, 1 ventricular d ysfunction, 1 complete heart block, 1 cardiac perforation, and 1 cereb rovascular accident). Conclusions: This report of a large series of ra diofrequency catheter ablation procedures performed at an institution committed to treating congenital heart disease and pediatric arrhythmi as confirms the safety and efficacy of this procedure. The pediatric c ardiologist/electrophysiologist treating such patients must be aware o f specific technical, anatomic, and electrophysiologic variations in t he pediatric patient that are critical to the success of this therapy.