Radiofrequency catheter ablation of cardiac arrhythmias in pediatric patients.

Since their introduction 4 years ago in children, radiofrequency ablation techniques for definitive management of cardiac arrhythmias have evolved dramatically. All forms of abnormal tachycardia in children are now amenable to ablation. The success rates are high, and the procedure-related and short-term risks of ablation are very low. Radiofrequency ablation offers significant advantages over cardiac surgery as well as over long-term or lifetime administration of antiarrhythmic medications. The application of these techniques to children requires, in addition to experience in electrophysiology, a thorough knowledge of developmental issues in children, pediatric catheterization techniques, and a detailed knowledge of congenital heart disease. Although the impressive safety of the technique in the short term suggests that it should be considered as first-choice therapy for children with serious tachyarrhythmias, unresolved questions about the long-term safety of the technique suggest that a cautious approach should be taken in the application of radiofrequency ablation to the pediatric age group, and particularly in younger children and infants.