The efficacy and safety of radiofrequency catheter ablation for cardiac arrhythmias in pediatric patients

Abstract

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.