TRANSHEPATIC ACCESS TO THE ATRIOVENTRICULAR RING FOR DELIVERY OF RADIOFREQUENCY ENERGY

Indroduction: Transcatheter radiofrequency ablation is an effective, s afe treatment of arrhythmias in children. However, despite technical a dvances, patients with obstructed venous access to the heart have not been candidates for this treatment. Methods and Results: Two children (8.2 and 10.9 kg) with complex congenital heart disease, supraventricu lar tachycardia, and obstructed venous access underwent successful rad iofrequency ablation of either a right (one patient) or left (one pati ent) accessory pathway using the transhepatic route to the heart. Conc lusion: This experience underscores the usefulness of the transhepatic approach in small patients, in patients with limited venous access, a nd in patients with complex congenital heart disease.