DEFINITE TREATMENT OF SUPRAVENTRICULAR TA CHYCARDIA BY CATHETER ABLATION USING RADIOFREQUENCY CURRENT IN CHILDREN AND ADOLESCENTS

Background: Catheter ablation using radiofrequency current has been pr oven to be an effective and save tool for the treatment of adult patie nts with accessory atrioventricular pathways and with atrioventricular nodal reentry tachycardia. This study was designed to analyse the eff icacy of this method in children and adolescents. Patients and methods : Using radiofrequency current, catheter ablation of an accessory path way or of AV nodal reentry tachycardia was performed in 13 patients (m ean age 12.7 years) with drug-refractory supraventricular tachycardia. Radiofrequency current was applied through a 6 French steerable cathe ter positioned against the mitral or tricuspid anulus. Criteria for ra diofrequency current application (at 70-degrees-C or with 30 W) were t he recording of an accessory pathway potential or a local atrioventric ular interval < 40 ms. In the patient with atrioventricular nodal reen try tachycardia, a potential of the slow pathway was recorded. Results : In 6 of 7 patients with left-sided accessory pathways and in 4 of 5 patients with right-sided connections, conduction over these pathways was permanently interrupted. In the patient with atrioventricular noda l reentry tachycardia, radiofrequency current eliminated the tachycard ia without affecting normal atrioventricular nodal condution. In a pat ient with an anteroseptal pathway, induction of atrioventricular block was inevitable. No other complications were noted. Conclusion: Cathet er ablation using radiofrequency current is a highly effective method for definite treatment of supraventricular tachycardia in children and adolescents.