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Transseptal Puncture for Catheter Ablation in Children

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Abstract

Transseptal puncture (TP) is used in pediatric patients to access the left atrium in left-sided arrhythmia catheter ablation. Performing this procedure can be difficult and risky, especially in small children. In this study, we aimed to evaluate the safety and feasibility of TPs in children ≤ 30 kg. Between April 2012 and April 2018, a retrospective evaluation was conducted of the clinical features, procedural outcomes, and follow-ups of ≤ 30 kg pediatric patients who required TPs for left-sided ablations at a pediatric electrophysiology center in which a three-dimensional mapping system was routinely used. A total of 45 pediatric patients who were ≤ 30 kg, underwent TPs: 10 patients ≤ 20 kg (Group 1) and 35 patients > 20 kg and ≤ 30 kg (Group 2). The TP success rate was 97.8%. The median procedure and fluoroscopy times were 120 min and 5.43 min, respectively. One patient developed self-limited pericardial effusion during the procedure; however, there were no incidences of cardiac tamponade. There was no significant difference between the two groups in terms of the procedure time and fluoroscopy time, and pericardial effusion was only observed in Group 2. TPs are safe and feasible in small children. These procedures can be performed with low complication rates in children weighing ≤ 30 kg.

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Authors and Affiliations

  1. Department of Pediatric Cardiology/Electrophysiology, Istanbul Medipol University Hospital, Istanbul, Turkey

    Serhat Koca, Celal Akdeniz & Volkan Tuzcu

  2. Yuksek Ihtisas Hospital, Kizilay St. Nu 4 Sihhiye, Ankara, Turkey

    Serhat Koca

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  1. Serhat Koca
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  2. Celal Akdeniz
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  3. Volkan Tuzcu
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Correspondence to Serhat Koca.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from the children’s parents/guardians.

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Koca, S., Akdeniz, C. & Tuzcu, V. Transseptal Puncture for Catheter Ablation in Children. Pediatr Cardiol 40, 799–804 (2019). https://doi.org/10.1007/s00246-019-02069-4

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  • DOI: https://doi.org/10.1007/s00246-019-02069-4

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