Radiofrequency catheter ablation of tachycardia in children with and without congenital heart disease: indications and limitations
Identifieur interne : 000698 ( Main/Corpus ); précédent : 000697; suivant : 000699Radiofrequency catheter ablation of tachycardia in children with and without congenital heart disease: indications and limitations
Auteurs : Mei-Hwan Wu ; Jiunn-Li Lin ; Lin-Pin Lai ; Ming-Lon Young ; Chun-Wei Lu ; Yung-Ching Chang ; Jou-Kou Wang ; Hung-Chi LueSource :
- International Journal of Cardiology [ 0167-5273 ] ; 1999.
Abstract
From 1993 to 1998, a total of 100 consecutive pediatric patients with tachycardia (45 male and 55 female, aged 1 year 10 months to 17 years, 11±4 year) who underwent electrophysiological study were reviewed. Eleven of them were younger than 5 years. Two had tachycardia-related cerebrovascular accident. Congenital heart disease was found in 12 patients. After propofol anesthesia, the clinical tachycardia could not be induced in three (two atrial tachycardia and one AV nodal re-entrant tachycardia) and became nonsustained in five (atrial tachycardia). Mechanical ablation occurred in three and two had subsequent recurrences. Among the 85 cases who received radiofrequency ablation, the overall final success rate of RF ablation for all diagnoses was 94% with a diagnosis-specific success rate ranging from 100 to 57%. Tachycardia cardiomyopathy was noted in four (three atrial tachycardia and one junctional ectopic tachycardia) and all regressed after successful ablation. Success in two patients with left posterioseptal accessory pathway could only be achieved by delivering the energy at the middle cardiac vein. Two patients with right atrial isomerism had an ‘AV nodal-to-AV nodal tachycardia’ which was eliminated by ablation. Total recurrence rate was 13% but final success was achieved in all during re-study except the three patients who refused re-intervention. The atrial tachycardia developed in postoperative congenital heart disease was associated with the lowest success rate (57%) and highest recurrence rate (25%). Procedure-related complications occurred in four; two with transient brachial palsy, one with first-degree AV block and one with blood loss requiring blood transfusion. In conclusion, the experience of this single center confirmed the efficacy and safety of radiofrequency catheter ablation in treating pediatric arrhythmias, but the limitations in postoperative arrhythmias and the effects of propofol on tachycardia induction (especially the atrial tachycardia) need to be improved.
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DOI: 10.1016/S0167-5273(99)00183-7
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last="Lai">Lin-Pin Lai</name><affiliation><mods:affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</mods:affiliation></affiliation></author><author><name sortKey="Young, Ming Lon" sort="Young, Ming Lon" uniqKey="Young M" first="Ming-Lon" last="Young">Ming-Lon Young</name><affiliation><mods:affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</mods:affiliation></affiliation></author><author><name sortKey="Lu, Chun Wei" sort="Lu, Chun Wei" uniqKey="Lu C" first="Chun-Wei" last="Lu">Chun-Wei Lu</name><affiliation><mods:affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</mods:affiliation></affiliation></author><author><name sortKey="Chang, Yung Ching" sort="Chang, Yung Ching" uniqKey="Chang Y" first="Yung-Ching" last="Chang">Yung-Ching Chang</name><affiliation><mods:affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</mods:affiliation></affiliation></author><author><name sortKey="Wang, Jou Kou" sort="Wang, Jou Kou" uniqKey="Wang J" first="Jou-Kou" last="Wang">Jou-Kou Wang</name><affiliation><mods:affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</mods:affiliation></affiliation></author><author><name sortKey="Lue, Hung Chi" sort="Lue, Hung Chi" uniqKey="Lue H" first="Hung-Chi" last="Lue">Hung-Chi Lue</name><affiliation><mods:affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:B9DBF0A131EC81223A51869E7652F51560947149</idno><date when="2000" year="2000">2000</date><idno type="doi">10.1016/S0167-5273(99)00183-7</idno><idno 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Taiwan</mods:affiliation></affiliation></author><author><name sortKey="Lai, Lin Pin" sort="Lai, Lin Pin" uniqKey="Lai L" first="Lin-Pin" last="Lai">Lin-Pin Lai</name><affiliation><mods:affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</mods:affiliation></affiliation></author><author><name sortKey="Young, Ming Lon" sort="Young, Ming Lon" uniqKey="Young M" first="Ming-Lon" last="Young">Ming-Lon Young</name><affiliation><mods:affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</mods:affiliation></affiliation></author><author><name sortKey="Lu, Chun Wei" sort="Lu, Chun Wei" uniqKey="Lu C" first="Chun-Wei" last="Lu">Chun-Wei Lu</name><affiliation><mods:affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</mods:affiliation></affiliation></author><author><name sortKey="Chang, Yung Ching" sort="Chang, Yung Ching" uniqKey="Chang Y" first="Yung-Ching" last="Chang">Yung-Ching Chang</name><affiliation><mods:affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</mods:affiliation></affiliation></author><author><name sortKey="Wang, Jou Kou" sort="Wang, Jou Kou" uniqKey="Wang J" first="Jou-Kou" last="Wang">Jou-Kou Wang</name><affiliation><mods:affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</mods:affiliation></affiliation></author><author><name sortKey="Lue, Hung Chi" sort="Lue, Hung Chi" uniqKey="Lue H" first="Hung-Chi" last="Lue">Hung-Chi Lue</name><affiliation><mods:affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">International Journal of Cardiology</title><title level="j" type="abbrev">IJCA</title><idno type="ISSN">0167-5273</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1999">1999</date><biblScope unit="volume">72</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="221">221</biblScope><biblScope unit="page" to="227">227</biblScope></imprint><idno type="ISSN">0167-5273</idno></series><idno type="istex">B9DBF0A131EC81223A51869E7652F51560947149</idno><idno type="DOI">10.1016/S0167-5273(99)00183-7</idno><idno type="PII">S0167-5273(99)00183-7</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0167-5273</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">From 1993 to 1998, a total of 100 consecutive pediatric patients with tachycardia (45 male and 55 female, aged 1 year 10 months to 17 years, 11±4 year) who underwent electrophysiological study were reviewed. Eleven of them were younger than 5 years. Two had tachycardia-related cerebrovascular accident. Congenital heart disease was found in 12 patients. After propofol anesthesia, the clinical tachycardia could not be induced in three (two atrial tachycardia and one AV nodal re-entrant tachycardia) and became nonsustained in five (atrial tachycardia). Mechanical ablation occurred in three and two had subsequent recurrences. Among the 85 cases who received radiofrequency ablation, the overall final success rate of RF ablation for all diagnoses was 94% with a diagnosis-specific success rate ranging from 100 to 57%. Tachycardia cardiomyopathy was noted in four (three atrial tachycardia and one junctional ectopic tachycardia) and all regressed after successful ablation. Success in two patients with left posterioseptal accessory pathway could only be achieved by delivering the energy at the middle cardiac vein. Two patients with right atrial isomerism had an ‘AV nodal-to-AV nodal tachycardia’ which was eliminated by ablation. Total recurrence rate was 13% but final success was achieved in all during re-study except the three patients who refused re-intervention. The atrial tachycardia developed in postoperative congenital heart disease was associated with the lowest success rate (57%) and highest recurrence rate (25%). Procedure-related complications occurred in four; two with transient brachial palsy, one with first-degree AV block and one with blood loss requiring blood transfusion. In conclusion, the experience of this single center confirmed the efficacy and safety of radiofrequency catheter ablation in treating pediatric arrhythmias, but the limitations in postoperative arrhythmias and the effects of propofol on tachycardia induction (especially the atrial tachycardia) need to be improved.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Mei-Hwan Wu M.D., Ph.D., F.A.C.C., F.E.S.C.</name><affiliations><json:string>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</json:string><json:string>E-mail: mhwu@ha.mc.ntu.edu.tw</json:string></affiliations></json:item><json:item><name>Jiunn-Li Lin M.D., Ph.D.</name><affiliations><json:string>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</json:string></affiliations></json:item><json:item><name>Lin-Pin Lai M.D.</name><affiliations><json:string>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</json:string></affiliations></json:item><json:item><name>Ming-Lon Young M.D., M.P.H., F.A.C.C.</name><affiliations><json:string>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</json:string></affiliations></json:item><json:item><name>Chun-Wei Lu M.D.</name><affiliations><json:string>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</json:string></affiliations></json:item><json:item><name>Yung-Ching Chang M.D.</name><affiliations><json:string>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</json:string></affiliations></json:item><json:item><name>Jou-Kou Wang M.D., Ph.D.</name><affiliations><json:string>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</json:string></affiliations></json:item><json:item><name>Hung-Chi Lue M.D., F.A.C.C.</name><affiliations><json:string>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</json:string></affiliations></json:item></author><language><json:string>eng</json:string></language><abstract>From 1993 to 1998, a total of 100 consecutive pediatric patients with tachycardia (45 male and 55 female, aged 1 year 10 months to 17 years, 11±4 year) who underwent electrophysiological study were reviewed. Eleven of them were younger than 5 years. Two had tachycardia-related cerebrovascular accident. Congenital heart disease was found in 12 patients. After propofol anesthesia, the clinical tachycardia could not be induced in three (two atrial tachycardia and one AV nodal re-entrant tachycardia) and became nonsustained in five (atrial tachycardia). Mechanical ablation occurred in three and two had subsequent recurrences. Among the 85 cases who received radiofrequency ablation, the overall final success rate of RF ablation for all diagnoses was 94% with a diagnosis-specific success rate ranging from 100 to 57%. Tachycardia cardiomyopathy was noted in four (three atrial tachycardia and one junctional ectopic tachycardia) and all regressed after successful ablation. Success in two patients with left posterioseptal accessory pathway could only be achieved by delivering the energy at the middle cardiac vein. Two patients with right atrial isomerism had an ‘AV nodal-to-AV nodal tachycardia’ which was eliminated by ablation. Total recurrence rate was 13% but final success was achieved in all during re-study except the three patients who refused re-intervention. The atrial tachycardia developed in postoperative congenital heart disease was associated with the lowest success rate (57%) and highest recurrence rate (25%). Procedure-related complications occurred in four; two with transient brachial palsy, one with first-degree AV block and one with blood loss requiring blood transfusion. In conclusion, the experience of this single center confirmed the efficacy and safety of radiofrequency catheter ablation in treating pediatric arrhythmias, but the limitations in postoperative arrhythmias and the effects of propofol on tachycardia induction (especially the atrial tachycardia) need to be improved.</abstract><qualityIndicators><score>6.996</score><pdfVersion>1.2</pdfVersion><pdfPageSize>598 x 792 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>2022</abstractCharCount><pdfWordCount>3996</pdfWordCount><pdfCharCount>26455</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>292</abstractWordCount></qualityIndicators><title>Radiofrequency catheter ablation of tachycardia in children with and without congenital heart disease: indications and limitations</title><pii><json:string>S0167-5273(99)00183-7</json:string></pii><genre><json:string>research-article</json:string></genre><host><volume>72</volume><pii><json:string>S0167-5273(00)X0082-4</json:string></pii><pages><last>227</last><first>221</first></pages><issn><json:string>0167-5273</json:string></issn><issue>3</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><title>International Journal of Cardiology</title><publicationDate>2000</publicationDate></host><categories><wos><json:string>CARDIAC & CARDIOVASCULAR SYSTEMS</json:string></wos></categories><publicationDate>1999</publicationDate><copyrightDate>2000</copyrightDate><doi><json:string>10.1016/S0167-5273(99)00183-7</json:string></doi><id>B9DBF0A131EC81223A51869E7652F51560947149</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/B9DBF0A131EC81223A51869E7652F51560947149/fulltext/pdf</uri></json:item><json:item><original>true</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/B9DBF0A131EC81223A51869E7652F51560947149/fulltext/txt</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/B9DBF0A131EC81223A51869E7652F51560947149/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/B9DBF0A131EC81223A51869E7652F51560947149/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Radiofrequency catheter ablation of tachycardia in children with and without congenital heart disease: indications and limitations</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>ELSEVIER</p></availability><date>2000</date></publicationStmt><notesStmt><note type="content">Fig. 1: The distribution of accessory pathways and the results of radiofrequency ablation in 61 patients (64 accessory pathways). The accessory pathways were located as right anterior (8), right lateral (10), right posterior (1), right posterioseptal (4), left posterioseptal (7), left posterior (5), left lateral (23), left anteriolateral (1) and paraHistian (5).</note><note type="content">Table 1: Types of tachycardia in patients without congenital heart disease</note><note type="content">Table 2: Types of tachycardia and associated congenital heart disease</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Radiofrequency catheter ablation of tachycardia in children with and without congenital heart disease: indications and limitations</title><author><persName><forename type="first">Mei-Hwan</forename><surname>Wu</surname></persName><roleName type="degree">M.D., Ph.D., F.A.C.C., F.E.S.C.</roleName><email>mhwu@ha.mc.ntu.edu.tw</email><note type="correspondence"><p>Corresponding author. Tel.: +886-2-2397-0800-5137; fax: +886-2-2341-2602</p></note><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation></author><author><persName><forename type="first">Jiunn-Li</forename><surname>Lin</surname></persName><roleName type="degree">M.D., Ph.D.</roleName><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation></author><author><persName><forename type="first">Lin-Pin</forename><surname>Lai</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation></author><author><persName><forename type="first">Ming-Lon</forename><surname>Young</surname></persName><roleName type="degree">M.D., M.P.H., F.A.C.C.</roleName><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation></author><author><persName><forename type="first">Chun-Wei</forename><surname>Lu</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation></author><author><persName><forename type="first">Yung-Ching</forename><surname>Chang</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation></author><author><persName><forename type="first">Jou-Kou</forename><surname>Wang</surname></persName><roleName type="degree">M.D., Ph.D.</roleName><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation></author><author><persName><forename type="first">Hung-Chi</forename><surname>Lue</surname></persName><roleName type="degree">M.D., F.A.C.C.</roleName><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation></author></analytic><monogr><title level="j">International Journal of Cardiology</title><title level="j" type="abbrev">IJCA</title><idno type="pISSN">0167-5273</idno><idno type="PII">S0167-5273(00)X0082-4</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1999"></date><biblScope unit="volume">72</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="221">221</biblScope><biblScope unit="page" to="227">227</biblScope></imprint></monogr><idno type="istex">B9DBF0A131EC81223A51869E7652F51560947149</idno><idno type="DOI">10.1016/S0167-5273(99)00183-7</idno><idno type="PII">S0167-5273(99)00183-7</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2000</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>From 1993 to 1998, a total of 100 consecutive pediatric patients with tachycardia (45 male and 55 female, aged 1 year 10 months to 17 years, 11±4 year) who underwent electrophysiological study were reviewed. Eleven of them were younger than 5 years. Two had tachycardia-related cerebrovascular accident. Congenital heart disease was found in 12 patients. After propofol anesthesia, the clinical tachycardia could not be induced in three (two atrial tachycardia and one AV nodal re-entrant tachycardia) and became nonsustained in five (atrial tachycardia). Mechanical ablation occurred in three and two had subsequent recurrences. Among the 85 cases who received radiofrequency ablation, the overall final success rate of RF ablation for all diagnoses was 94% with a diagnosis-specific success rate ranging from 100 to 57%. Tachycardia cardiomyopathy was noted in four (three atrial tachycardia and one junctional ectopic tachycardia) and all regressed after successful ablation. Success in two patients with left posterioseptal accessory pathway could only be achieved by delivering the energy at the middle cardiac vein. Two patients with right atrial isomerism had an ‘AV nodal-to-AV nodal tachycardia’ which was eliminated by ablation. Total recurrence rate was 13% but final success was achieved in all during re-study except the three patients who refused re-intervention. The atrial tachycardia developed in postoperative congenital heart disease was associated with the lowest success rate (57%) and highest recurrence rate (25%). Procedure-related complications occurred in four; two with transient brachial palsy, one with first-degree AV block and one with blood loss requiring blood transfusion. In conclusion, the experience of this single center confirmed the efficacy and safety of radiofrequency catheter ablation in treating pediatric arrhythmias, but the limitations in postoperative arrhythmias and the effects of propofol on tachycardia induction (especially the atrial tachycardia) need to be improved.</p></abstract></profileDesc><revisionDesc><change when="1999-09-30">Registration</change><change when="1999-08-19">Modified</change><change when="1999">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: ce:floats; body; tail"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"><istex:entity SYSTEM="gr1" NDATA="IMAGE" name="gr1"></istex:entity></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla"><item-info><jid>IJCA</jid><aid>3791</aid><ce:pii>S0167-5273(99)00183-7</ce:pii><ce:doi>10.1016/S0167-5273(99)00183-7</ce:doi><ce:copyright type="full-transfer" year="2000">Elsevier Science Ireland Ltd</ce:copyright></item-info><head><ce:title>Radiofrequency catheter ablation of tachycardia in children with and without congenital heart disease: indications and limitations</ce:title><ce:author-group><ce:author><ce:given-name>Mei-Hwan</ce:given-name><ce:surname>Wu</ce:surname><ce:degrees>M.D., Ph.D., F.A.C.C., F.E.S.C.</ce:degrees><ce:cross-ref refid="CORR1">*</ce:cross-ref><ce:e-address>mhwu@ha.mc.ntu.edu.tw</ce:e-address></ce:author><ce:author><ce:given-name>Jiunn-Li</ce:given-name><ce:surname>Lin</ce:surname><ce:degrees>M.D., Ph.D.</ce:degrees></ce:author><ce:author><ce:given-name>Lin-Pin</ce:given-name><ce:surname>Lai</ce:surname><ce:degrees>M.D.</ce:degrees></ce:author><ce:author><ce:given-name>Ming-Lon</ce:given-name><ce:surname>Young</ce:surname><ce:degrees>M.D., M.P.H., F.A.C.C.</ce:degrees></ce:author><ce:author><ce:given-name>Chun-Wei</ce:given-name><ce:surname>Lu</ce:surname><ce:degrees>M.D.</ce:degrees></ce:author><ce:author><ce:given-name>Yung-Ching</ce:given-name><ce:surname>Chang</ce:surname><ce:degrees>M.D.</ce:degrees></ce:author><ce:author><ce:given-name>Jou-Kou</ce:given-name><ce:surname>Wang</ce:surname><ce:degrees>M.D., Ph.D.</ce:degrees></ce:author><ce:author><ce:given-name>Hung-Chi</ce:given-name><ce:surname>Lue</ce:surname><ce:degrees>M.D., F.A.C.C.</ce:degrees></ce:author><ce:affiliation><ce:textfn>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</ce:textfn></ce:affiliation><ce:correspondence id="CORR1"><ce:label>*</ce:label><ce:text>Corresponding author. Tel.: +886-2-2397-0800-5137; fax: +886-2-2341-2602</ce:text></ce:correspondence></ce:author-group><ce:date-received day="20" month="4" year="1999"></ce:date-received><ce:date-revised day="19" month="8" year="1999"></ce:date-revised><ce:date-accepted day="30" month="9" year="1999"></ce:date-accepted><ce:abstract><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para>From 1993 to 1998, a total of 100 consecutive pediatric patients with tachycardia (45 male and 55 female, aged 1 year 10 months to 17 years, 11±4 year) who underwent electrophysiological study were reviewed. Eleven of them were younger than 5 years. Two had tachycardia-related cerebrovascular accident. Congenital heart disease was found in 12 patients. After propofol anesthesia, the clinical tachycardia could not be induced in three (two atrial tachycardia and one AV nodal re-entrant tachycardia) and became nonsustained in five (atrial tachycardia). Mechanical ablation occurred in three and two had subsequent recurrences. Among the 85 cases who received radiofrequency ablation, the overall final success rate of RF ablation for all diagnoses was 94% with a diagnosis-specific success rate ranging from 100 to 57%. Tachycardia cardiomyopathy was noted in four (three atrial tachycardia and one junctional ectopic tachycardia) and all regressed after successful ablation. Success in two patients with left posterioseptal accessory pathway could only be achieved by delivering the energy at the middle cardiac vein. Two patients with right atrial isomerism had an ‘AV nodal-to-AV nodal tachycardia’ which was eliminated by ablation. Total recurrence rate was 13% but final success was achieved in all during re-study except the three patients who refused re-intervention. The atrial tachycardia developed in postoperative congenital heart disease was associated with the lowest success rate (57%) and highest recurrence rate (25%). Procedure-related complications occurred in four; two with transient brachial palsy, one with first-degree AV block and one with blood loss requiring blood transfusion. In conclusion, the experience of this single center confirmed the efficacy and safety of radiofrequency catheter ablation in treating pediatric arrhythmias, but the limitations in postoperative arrhythmias and the effects of propofol on tachycardia induction (especially the atrial tachycardia) need to be improved.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Radiofrequency catheter ablation of tachycardia in children with and without congenital heart disease: indications and limitations</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Radiofrequency catheter ablation of tachycardia in children with and without congenital heart disease: indications and limitations</title></titleInfo><name type="personal"><namePart type="given">Mei-Hwan</namePart><namePart type="family">Wu</namePart><namePart type="termsOfAddress">M.D., Ph.D., F.A.C.C., F.E.S.C.</namePart><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation><affiliation>E-mail: mhwu@ha.mc.ntu.edu.tw</affiliation><description>Corresponding author. Tel.: +886-2-2397-0800-5137; fax: +886-2-2341-2602</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jiunn-Li</namePart><namePart type="family">Lin</namePart><namePart type="termsOfAddress">M.D., Ph.D.</namePart><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lin-Pin</namePart><namePart type="family">Lai</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ming-Lon</namePart><namePart type="family">Young</namePart><namePart type="termsOfAddress">M.D., M.P.H., F.A.C.C.</namePart><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Chun-Wei</namePart><namePart type="family">Lu</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yung-Ching</namePart><namePart type="family">Chang</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jou-Kou</namePart><namePart type="family">Wang</namePart><namePart type="termsOfAddress">M.D., Ph.D.</namePart><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Hung-Chi</namePart><namePart type="family">Lue</namePart><namePart type="termsOfAddress">M.D., F.A.C.C.</namePart><affiliation>Department of Pediatrics and Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1999</dateIssued><dateValid encoding="w3cdtf">1999-09-30</dateValid><dateModified encoding="w3cdtf">1999-08-19</dateModified><copyrightDate encoding="w3cdtf">2000</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">From 1993 to 1998, a total of 100 consecutive pediatric patients with tachycardia (45 male and 55 female, aged 1 year 10 months to 17 years, 11±4 year) who underwent electrophysiological study were reviewed. Eleven of them were younger than 5 years. Two had tachycardia-related cerebrovascular accident. Congenital heart disease was found in 12 patients. After propofol anesthesia, the clinical tachycardia could not be induced in three (two atrial tachycardia and one AV nodal re-entrant tachycardia) and became nonsustained in five (atrial tachycardia). Mechanical ablation occurred in three and two had subsequent recurrences. Among the 85 cases who received radiofrequency ablation, the overall final success rate of RF ablation for all diagnoses was 94% with a diagnosis-specific success rate ranging from 100 to 57%. Tachycardia cardiomyopathy was noted in four (three atrial tachycardia and one junctional ectopic tachycardia) and all regressed after successful ablation. Success in two patients with left posterioseptal accessory pathway could only be achieved by delivering the energy at the middle cardiac vein. Two patients with right atrial isomerism had an ‘AV nodal-to-AV nodal tachycardia’ which was eliminated by ablation. Total recurrence rate was 13% but final success was achieved in all during re-study except the three patients who refused re-intervention. The atrial tachycardia developed in postoperative congenital heart disease was associated with the lowest success rate (57%) and highest recurrence rate (25%). Procedure-related complications occurred in four; two with transient brachial palsy, one with first-degree AV block and one with blood loss requiring blood transfusion. In conclusion, the experience of this single center confirmed the efficacy and safety of radiofrequency catheter ablation in treating pediatric arrhythmias, but the limitations in postoperative arrhythmias and the effects of propofol on tachycardia induction (especially the atrial tachycardia) need to be improved.</abstract><note type="content">Fig. 1: The distribution of accessory pathways and the results of radiofrequency ablation in 61 patients (64 accessory pathways). The accessory pathways were located as right anterior (8), right lateral (10), right posterior (1), right posterioseptal (4), left posterioseptal (7), left posterior (5), left lateral (23), left anteriolateral (1) and paraHistian (5).</note><note type="content">Table 1: Types of tachycardia in patients without congenital heart disease</note><note type="content">Table 2: Types of tachycardia and associated congenital heart disease</note><relatedItem type="host"><titleInfo><title>International Journal of Cardiology</title></titleInfo><titleInfo type="abbreviated"><title>IJCA</title></titleInfo><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">20000215</dateIssued></originInfo><identifier type="ISSN">0167-5273</identifier><identifier type="PII">S0167-5273(00)X0082-4</identifier><part><date>20000215</date><detail type="volume"><number>72</number><caption>vol.</caption></detail><detail type="issue"><number>3</number><caption>no.</caption></detail><extent unit="issue pages"><start>203</start><end>318</end></extent><extent unit="pages"><start>221</start><end>227</end></extent></part></relatedItem><identifier type="istex">B9DBF0A131EC81223A51869E7652F51560947149</identifier><identifier type="DOI">10.1016/S0167-5273(99)00183-7</identifier><identifier type="PII">S0167-5273(99)00183-7</identifier><accessCondition type="use and reproduction" contentType="">© 2000Elsevier Science Ireland Ltd</accessCondition><recordInfo><recordContentSource>ELSEVIER</recordContentSource><recordOrigin>Elsevier Science Ireland Ltd, ©2000</recordOrigin></recordInfo></mods></metadata><enrichments><istex:catWosTEI uri="https://api.istex.fr/document/B9DBF0A131EC81223A51869E7652F51560947149/enrichments/catWos"><teiHeader><profileDesc><textClass><classCode scheme="WOS">CARDIAC & CARDIOVASCULAR SYSTEMS</classCode></textClass></profileDesc></teiHeader></istex:catWosTEI></enrichments><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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