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Catheter ablation of idiopathic right ventricular arrhythmias in children with limited fluoroscopy

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Abstract

Introduction

Definitive therapy of idiopathic right ventricular arrhythmias (VA) remains a challenge in interventional electrophysiology. The aim of this study was to evaluate the utility of EnSite Velocity system in the catheter ablation of RV tachycardia in children.

Methods

Thirty-five children with idiopathic right VA underwent catheter ablation procedure using the EnSite Velocity system guidance.

Results

The mean patient age was 12.0 ± 3.7 years and the mean patient weight was 43.6 ± 18.7 kg. The origin of right VA was divided into right ventricular outflow tract (RVOT) (30 patients) and other right ventricular localizations (five patients). The mean procedure and fluoroscopy times were 175 ± 67 min and 2.35 ± 1.89 min, respectively. No fluoroscopy was used in 19 patients. Acute success was achieved in 29 patients (83 %). The focus of VA was epicardial in three failed procedures. Cryocatheter (6-mm or 8-mm tip) was used in six patients, radiofrequency ablation (RFA) (4-mm or 8-mm tip) in 26 patients, and 4-mm tip irrigated RFA in three patients. During a mean follow-up of 15.9 ± 7.1 months, ventricular tachycardia recurred in six patients (20 %). There were three complications (transient atrioventricular block developed in one patient during parahissian cryoablation and two patients developed transient complete right bundle branch block).

Conclusions

Catheter ablation of idiopathic right VA in children can be performed safely and effectively with limited fluoroscopy using the EnSite Velocity system.

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Authors and Affiliations

  1. Pediatric and Genetic Arrhythmia Center, Pediatric Cardiology, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe Cikisi, No 1, Bagcilar, 14, Istanbul, Turkey

    Celal Akdeniz, Enes Elvin Gul, Nida Celik, Mehmet Karacan & Volkan Tuzcu

Authors
  1. Celal Akdeniz
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  2. Enes Elvin Gul
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  3. Nida Celik
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  4. Mehmet Karacan
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  5. Volkan Tuzcu
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Corresponding author

Correspondence to Volkan Tuzcu.

Ethics declarations

All patients and/or their legal guardians gave verbal and written consent for the procedure.

Conflict of interest

The manuscript, as submitted or its essence in another version, is not under consideration for publication elsewhere, and will not be published elsewhere while under consideration by Journal of Interventional Cardiac Electrophysiology. The authors have no commercial associations or sources of support that might pose a conflict of interest. All authors have made substantive contributions to the study, and all authors endorse the data and conclusions.

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Akdeniz, C., Gul, E.E., Celik, N. et al. Catheter ablation of idiopathic right ventricular arrhythmias in children with limited fluoroscopy. J Interv Card Electrophysiol 46, 355–360 (2016). https://doi.org/10.1007/s10840-016-0133-6

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  • DOI: https://doi.org/10.1007/s10840-016-0133-6

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