The Efficacy and Safety of Radiofrequency Catheter Ablation for Cardiac Arrhythmias in Pediatric Patients.

BACKGROUND

We aimed to evaluate the acute and long-term efficacy and safety of radiofrequency catheter ablation (RFCA) in Chinese pediatric patients with arrhythmias.

METHODS

We gathered clinical data from pediatric patients who underwent RFCA in several large medical centers in China between 2000 and 2019.

RESULTS

A total of 4,622 different substrates in 4,622 patients were ablated, with the majority consisting of supraventricular tachycardia (N = 3,831, 82.9%) and ventricular arrhythmias (VAs) (N = 791, 17.1%). The majority of supraventricular tachycardia (SVT) consists of atrioventricular reentry tachycardia (AVRT) (N = 2,492, 65.0%) and atrioventricular nodal reentry tachycardia (AVNRT) (N = 1,075, 28.1%). The accessory pathway location was left-sided in 1,237(49.7%) and right-sided in 1,251(50.3%) of the 2,488 pathways. The VAs consist of premature ventricular contraction (PVC) (N = 597, 75.5%) and ventricular tachycardia (VT) (N = 194, 24.5%). The duration of follow-up ranged from 1 month to 1 year. The overall acute/long-term success rate of RFCA was 96.4%/92.2%, AVRT 97.8%/93.5%, AVRT 99.3%/95.0, PVC 98.1%/92.2%, and VT 81.3%/75.2%. Serious complications occurred in 29 patients (0.6%).

CONCLUSIONS

This present study shows that RFCA is effective and safe in the treatment of arrhythmias in Chinese pediatric patients, with a high success rate exceeding 90%, low recurrence rate, and significantly reduces the risk of complications. The success rate of left-sided pathway ablation is slightly higher than that of the right-sided pathway. There is no difference in the success rate of RFCA among children of different ages. It could be the first-line therapy in the majority of pediatric patients with SVT and/or VAs.