Pediatric Cardiology

, Volume 26, Issue 5, pp 622–626 | Cite as

Radiofrequency Ablation for Supraventricular Tachycardia in Children ≤15 kg Is Safe and Effective

  • R. Aiyagari
  • E.V. Saarel
  • S.P. Etheridge
  • D.J. Bradley
  • M.  DickII
  • P.S. Fischbach


Risks associated with radiofrequency ablation (RFA) have been reported to be increased in children ≤15 kg. We sought to compare the safety and efficacy of RFA in children <15 kg with those between 15.1 and 20 kg. Clinical, electrophysiologic, and RFA data for all patients ≤20 kg who underwent RFA for supraventricular tachycardia between January 1994 and January 2003 were reviewed. Patients were divided into those ≤15 kg (group 1, n = 25) and those between 15.1 and 20 kg (group 2, n = 44). The two groups differed significantly in age and weight by design (group 1: mean weight, 11.9 ± 3.0 kg; age, 2.8 ± 1.9 years; group 2: weight, 18.0 ± 1.5 kg; age, 5.1 ± 1.1 years). There were no significant differences in other baseline characteristics except for incidence of structural heart disease (28% group 1 vs 7% group 2, p < 0.01). No significant differences in mechanism of tachycardia, arrhythmia cycle length, number of total and brief RFA applications, total RFA time, average and maximum RFA temperatures, total procedure duration, short-term success rate (96% group 1 vs 86% group 2, p = 0.17), long-term success rate (91% group 1 vs 89% group 2, p = 0.76), or major complications (8.0% group 1 vs 2.3% group 2, p = 0.39) were found. There were no procedure-related deaths in either group. These data suggest that, in two large volume electrophysiology centers, the procedural risks and outcomes of RFA are similar between patients weighing less than 15 kg and those between 15.1 and 20 kg.


Radiofrequency ablation Supraventricular tachycardia 


  1. 1.
    Blaufox, AD, Felix, GL, Saul, JP 2001Radiofrequency catheter ablation in infants </ = 18 months old: when is it done and how do they fare? Short-term data from the pediatric ablation registryCirculation10428032808PubMedGoogle Scholar
  2. 2.
    Bokenkamp, R, Wibbelt, G, Sturm, M,  et al. 2000Effects of intracardiac radiofrequency current application on coronary artery vessels in young pigsJ Cardiovasc Electrophysiol11565571PubMedGoogle Scholar
  3. 3.
    Case, CL, Gillette, PC, Oslizlok, PC,  et al. 1992Radiofrequency catheter ablation of incessant, medically resistant supraventricular tachycardia in infants and small childrenJ Am Coll Cardiol2014051410PubMedCrossRefGoogle Scholar
  4. 4.
    Collins, KK, Chiesa, NA, Dubin, AM,  et al. 2002Clinical outcomes of children with normal cardiac anatomy having radiofrequency catheter ablation > or =10 years earlierAm J Cardiol89471475PubMedCrossRefGoogle Scholar
  5. 5.
    Dick, M,2nd, Law, IH, Dorostkar, PC,  et al. 1996Use of the His/RVA electrode catheter in childrenJ Electrocardiol29227233PubMedGoogle Scholar
  6. 6.
    Dick, M,2nd, O’Connor, BK, Serwer, GA,  et al. 1991Use of radiofrequency current to ablate accessory connections in childrenCirculation8423182324PubMedGoogle Scholar
  7. 7.
    Kantoch, MJ 1995Combination of amiodarone and flecainideAm J Cardiol75862PubMedCrossRefGoogle Scholar
  8. 8.
    Kugler, JD, Danford, DA, Deal, BJ,  et al. 1994Radiofrequency catheter ablation for tachyarrhythmias in children and adolescents. The Pediatric Electrophysiology SocietyN Engl Med33014811487CrossRefGoogle Scholar
  9. 9.
    Kugler, JD, Danford, DA, Houston, K,  et al. 1997Radiofrequency catheter ablation for paroxysmal supraventricular tachycardia in children and adolescents without structural heart disease. Pediatric EP Society, Radiofrequency Catheter Ablation RegistryAm J Cardiol8014381443PubMedCrossRefGoogle Scholar
  10. 10.
    Price, IF, Kertesz, NT, Snyder, CS,  et al. 2002Flecainide and sotalol: a new combination therapy for refractory supraventricular tachycardia in children <1 year of ageJ Am Coll Cardiol39517520PubMedCrossRefGoogle Scholar
  11. 11.
    Saul, JP, Hulse, JE, Papagiannis, J,  et al. 1994Late enlargement of radiofrequency lesions in infant lambs. Implications for ablation procedures in small childrenCirculation90492499PubMedGoogle Scholar
  12. 12.
    Schluter, M, Kuck, KH 1992Radiofrequency current for catheter ablation of accessory atrioventricular connections in children and adolescents. Emphasis on the single-catheter techniquePediatrics89930935PubMedGoogle Scholar
  13. 13.
    Hare, GF, Lesh, MD, Scheinman, M,  et al. 1991Percutaneous radiofrequency catheter ablation for supraventricular arrhythmias in childrenJ Am Coll Cardiol1716131620PubMedGoogle Scholar
  14. 14.
    Hare, GF, Witherell, CL, Lesh, MD 1994Follow-up of radiofrequency catheter ablation in children: results in 100 consecutive patientsJ Am Coll Cardiol2316511659PubMedGoogle Scholar
  15. 15.
    Walsh, EP, Saul, JP 1991Transcatheter ablation for pediatric tachyarrhythmias using radiofrequency electrical energyPediatr Ann20386392PubMedGoogle Scholar
  16. 16.
    Friedman, RA, Walsh, EP, Silka, MJ,  et al. 2002NASPE Expert Consensus Conference: radiofrequency catheter ablation in children with and without congenital heart disease. Report of the writing committee. North American Society of Pacing and ElectrophysiologyPacing Clin Electrophysiol2510001017PubMedGoogle Scholar
  17. 17.
    Walsh, EP, Saul, JP, Hulse, JE,  et al. 1992Transcatheter ablation of ectopic atrial tachycardia in young patients using radiofrequency currentCirculation8611381146PubMedGoogle Scholar
  18. 18.
    Weindling, SN, Saul, JP, Walsh, EP 1996Efficacy and risks of medical therapy for supraventricular tachycardia in neonates and infantsAm Heart J1316672PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • R. Aiyagari
    • 1
  • E.V. Saarel
    • 1
  • S.P. Etheridge
    • 2
  • D.J. Bradley
    • 2
  • M.  DickII
    • 1
  • P.S. Fischbach
    • 1
  1. 1.C.S. Mott Children’s HospitalUniversity of Michigan Medical CenterAnn ArborUSA
  2. 2.University of UtahSalt Lake CityUSA

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