Catheter ablation using radiofrequency or low-energy direct current in pediatric patients with the Wolff-Parkinson-White syndrome
Identifieur interne : 000F14 ( Main/Corpus ); précédent : 000F13; suivant : 000F15Catheter ablation using radiofrequency or low-energy direct current in pediatric patients with the Wolff-Parkinson-White syndrome
Auteurs : Robert Lemery ; Mario Talajic ; Denis Roy ; Anne Fournier ; Benoit Coutu ; John Ty Hii ; David Radzik ; Linda LavoieSource :
- The American Journal of Cardiology [ 0002-9149 ] ; 1993.
Abstract
Percutaneous ablation of accessory pathways was performed in 22 consecutive children and adolescents (9 boys and 13 girls, age range 8 to 18 years). Low-energy direct current (DC) was used exclusively in the first 6 patients, whereas ablation was performed with radiofrequency energy in the following 16. Accessory pathways were located in the left free wall in 15 patients, were posteroseptal in 3, were in the right free wall in 3 and were anteroseptal in 1. A concealed accessory pathway was present in 7 patients (32%). There was no significant difference in clinical or electrophysiologic variables between both groups. Catheter ablation was successful in the initial 6 patients using low-energy DC, as compared with 13 of 16 patients using radiofrequency ablation. Low-energy DC was successful as a backup power source in all 3 patients who had unsuccessful radiofrequency ablation. There was no complication. The median procedural and fluoroscopic times for successful ablation were 2.5 hours and 49 minutes, respectively (p = NS between both power sources). Accessory pathway conduction recurred in 2 patients (33%) who had low-energy DC as compared with 1 (6%) who had radiofrequency ablation (p = NS). These 3 patients had successful reablation of their accessory pathways. In children and adolescents with accessory pathways, both new power sources compare favorably, with an overall success rate of ablation of 100% (22 of 22 patients). Radiofrequency ablation should be used initially because it does not require general anesthesia and is associated with a lower rate of recurrence of accessory pathway conduction. Low-energy DC may be most useful as a backup in patients who initially have unsuccessful radiofrequency ablation.
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DOI: 10.1016/0002-9149(94)90213-5
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Montreal, Canada</mods:affiliation></affiliation></author><author><name sortKey="Fournier, Anne" sort="Fournier, Anne" uniqKey="Fournier A" first="Anne" last="Fournier">Anne Fournier</name><affiliation><mods:affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</mods:affiliation></affiliation></author><author><name sortKey="Coutu, Benoit" sort="Coutu, Benoit" uniqKey="Coutu B" first="Benoit" last="Coutu">Benoit Coutu</name><affiliation><mods:affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</mods:affiliation></affiliation></author><author><name sortKey="Hii, John Ty" sort="Hii, John Ty" uniqKey="Hii J" first="John Ty" last="Hii">John Ty Hii</name><affiliation><mods:affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</mods:affiliation></affiliation></author><author><name sortKey="Radzik, David" sort="Radzik, David" uniqKey="Radzik D" first="David" last="Radzik">David 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patients with the Wolff-Parkinson-White syndrome</title><author><name sortKey="Lemery, Robert" sort="Lemery, Robert" uniqKey="Lemery R" first="Robert" last="Lemery">Robert Lemery</name><affiliation><mods:affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</mods:affiliation></affiliation></author><author><name sortKey="Talajic, Mario" sort="Talajic, Mario" uniqKey="Talajic M" first="Mario" last="Talajic">Mario Talajic</name><affiliation><mods:affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</mods:affiliation></affiliation></author><author><name sortKey="Roy, Denis" sort="Roy, Denis" uniqKey="Roy D" first="Denis" last="Roy">Denis Roy</name><affiliation><mods:affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</mods:affiliation></affiliation></author><author><name sortKey="Fournier, Anne" sort="Fournier, Anne" uniqKey="Fournier A" first="Anne" last="Fournier">Anne 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sortKey="Lavoie, Linda" sort="Lavoie, Linda" uniqKey="Lavoie L" first="Linda" last="Lavoie">Linda Lavoie</name><affiliation><mods:affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="ISSN">0002-9149</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1993">1993</date><biblScope unit="volume">73</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="191">191</biblScope><biblScope unit="page" to="194">194</biblScope></imprint><idno type="ISSN">0002-9149</idno></series><idno type="istex">E2D7375BC26AFD449FEE9E2BC93CA9F1A965052B</idno><idno type="DOI">10.1016/0002-9149(94)90213-5</idno><idno type="PII">0002-9149(94)90213-5</idno><idno type="ArticleID">94902135</idno></biblStruct></sourceDesc><seriesStmt><idno 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Low-energy direct current (DC) was used exclusively in the first 6 patients, whereas ablation was performed with radiofrequency energy in the following 16. Accessory pathways were located in the left free wall in 15 patients, were posteroseptal in 3, were in the right free wall in 3 and were anteroseptal in 1. A concealed accessory pathway was present in 7 patients (32%). There was no significant difference in clinical or electrophysiologic variables between both groups. Catheter ablation was successful in the initial 6 patients using low-energy DC, as compared with 13 of 16 patients using radiofrequency ablation. Low-energy DC was successful as a backup power source in all 3 patients who had unsuccessful radiofrequency ablation. There was no complication. The median procedural and fluoroscopic times for successful ablation were 2.5 hours and 49 minutes, respectively (p = NS between both power sources). Accessory pathway conduction recurred in 2 patients (33%) who had low-energy DC as compared with 1 (6%) who had radiofrequency ablation (p = NS). These 3 patients had successful reablation of their accessory pathways. In children and adolescents with accessory pathways, both new power sources compare favorably, with an overall success rate of ablation of 100% (22 of 22 patients). Radiofrequency ablation should be used initially because it does not require general anesthesia and is associated with a lower rate of recurrence of accessory pathway conduction. Low-energy DC may be most useful as a backup in patients who initially have unsuccessful radiofrequency ablation.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Robert Lemery MD</name><affiliations><json:string>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</json:string></affiliations></json:item><json:item><name>Mario Talajic MD</name><affiliations><json:string>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</json:string></affiliations></json:item><json:item><name>Denis Roy MD</name><affiliations><json:string>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</json:string></affiliations></json:item><json:item><name>Anne Fournier MD</name><affiliations><json:string>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</json:string></affiliations></json:item><json:item><name>Benoit Coutu MD</name><affiliations><json:string>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</json:string></affiliations></json:item><json:item><name>John TY Hii MD</name><affiliations><json:string>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</json:string></affiliations></json:item><json:item><name>David Radzik MD</name><affiliations><json:string>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</json:string></affiliations></json:item><json:item><name>Linda Lavoie BSc</name><affiliations><json:string>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Congenital heart disease</value></json:item></subject><articleId><json:string>94902135</json:string></articleId><language><json:string>eng</json:string></language><abstract>Percutaneous ablation of accessory pathways was performed in 22 consecutive children and adolescents (9 boys and 13 girls, age range 8 to 18 years). Low-energy direct current (DC) was used exclusively in the first 6 patients, whereas ablation was performed with radiofrequency energy in the following 16. Accessory pathways were located in the left free wall in 15 patients, were posteroseptal in 3, were in the right free wall in 3 and were anteroseptal in 1. A concealed accessory pathway was present in 7 patients (32%). There was no significant difference in clinical or electrophysiologic variables between both groups. Catheter ablation was successful in the initial 6 patients using low-energy DC, as compared with 13 of 16 patients using radiofrequency ablation. Low-energy DC was successful as a backup power source in all 3 patients who had unsuccessful radiofrequency ablation. There was no complication. The median procedural and fluoroscopic times for successful ablation were 2.5 hours and 49 minutes, respectively (p = NS between both power sources). Accessory pathway conduction recurred in 2 patients (33%) who had low-energy DC as compared with 1 (6%) who had radiofrequency ablation (p = NS). These 3 patients had successful reablation of their accessory pathways. In children and adolescents with accessory pathways, both new power sources compare favorably, with an overall success rate of ablation of 100% (22 of 22 patients). Radiofrequency ablation should be used initially because it does not require general anesthesia and is associated with a lower rate of recurrence of accessory pathway conduction. Low-energy DC may be most useful as a backup in patients who initially have unsuccessful radiofrequency ablation.</abstract><qualityIndicators><score>5.904</score><pdfVersion>1.3</pdfVersion><pdfPageSize>576.28 x 792 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>1</keywordCount><abstractCharCount>1741</abstractCharCount><pdfWordCount>2904</pdfWordCount><pdfCharCount>18979</pdfCharCount><pdfPageCount>4</pdfPageCount><abstractWordCount>269</abstractWordCount></qualityIndicators><title>Catheter ablation using radiofrequency or low-energy direct current in pediatric patients with the Wolff-Parkinson-White 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64111.</note><affiliation>Address for reprints: Robert Lemery, MD, Cardiovascular Consultants, Mid-America Heart Institute, 4330 Wornall, Suite 2000, Kansas City, Missouri 64111.</affiliation><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation></author><author><persName><forename type="first">Mario</forename><surname>Talajic</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation></author><author><persName><forename type="first">Denis</forename><surname>Roy</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation></author><author><persName><forename type="first">Anne</forename><surname>Fournier</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation></author><author><persName><forename type="first">Benoit</forename><surname>Coutu</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation></author><author><persName><forename type="first">John TY</forename><surname>Hii</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation></author><author><persName><forename type="first">David</forename><surname>Radzik</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation></author><author><persName><forename type="first">Linda</forename><surname>Lavoie</surname></persName><roleName type="degree">BSc</roleName><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation></author></analytic><monogr><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="pISSN">0002-9149</idno><idno type="PII">S0002-9149(00)X0654-6</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1993"></date><biblScope unit="volume">73</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="191">191</biblScope><biblScope unit="page" to="194">194</biblScope></imprint></monogr><idno type="istex">E2D7375BC26AFD449FEE9E2BC93CA9F1A965052B</idno><idno type="DOI">10.1016/0002-9149(94)90213-5</idno><idno type="PII">0002-9149(94)90213-5</idno><idno type="ArticleID">94902135</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1994</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Percutaneous ablation of accessory pathways was performed in 22 consecutive children and adolescents (9 boys and 13 girls, age range 8 to 18 years). Low-energy direct current (DC) was used exclusively in the first 6 patients, whereas ablation was performed with radiofrequency energy in the following 16. Accessory pathways were located in the left free wall in 15 patients, were posteroseptal in 3, were in the right free wall in 3 and were anteroseptal in 1. A concealed accessory pathway was present in 7 patients (32%). There was no significant difference in clinical or electrophysiologic variables between both groups. Catheter ablation was successful in the initial 6 patients using low-energy DC, as compared with 13 of 16 patients using radiofrequency ablation. Low-energy DC was successful as a backup power source in all 3 patients who had unsuccessful radiofrequency ablation. There was no complication. The median procedural and fluoroscopic times for successful ablation were 2.5 hours and 49 minutes, respectively (p = NS between both power sources). Accessory pathway conduction recurred in 2 patients (33%) who had low-energy DC as compared with 1 (6%) who had radiofrequency ablation (p = NS). These 3 patients had successful reablation of their accessory pathways. In children and adolescents with accessory pathways, both new power sources compare favorably, with an overall success rate of ablation of 100% (22 of 22 patients). Radiofrequency ablation should be used initially because it does not require general anesthesia and is associated with a lower rate of recurrence of accessory pathway conduction. Low-energy DC may be most useful as a backup in patients who initially have unsuccessful radiofrequency ablation.</p></abstract><textClass><keywords scheme="keyword"><list><head>Article category</head><item><term>Congenital heart disease</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1993-07-13">Registration</change><change when="1993-07-10">Modified</change><change when="1993">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: 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:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>AJC</jid><aid>94902135</aid><ce:pii>0002-9149(94)90213-5</ce:pii><ce:doi>10.1016/0002-9149(94)90213-5</ce:doi><ce:copyright type="unknown" year="1994"></ce:copyright><ce:doctopics><ce:doctopic><ce:text>Congenital heart disease</ce:text></ce:doctopic></ce:doctopics></item-info><head><ce:title>Catheter ablation using radiofrequency or low-energy direct current in pediatric patients with the Wolff-Parkinson-White syndrome</ce:title><ce:author-group><ce:author><ce:given-name>Robert</ce:given-name><ce:surname>Lemery</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="COR1"><ce:sup loc="post">∗</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Mario</ce:given-name><ce:surname>Talajic</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Denis</ce:given-name><ce:surname>Roy</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Anne</ce:given-name><ce:surname>Fournier</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Benoit</ce:given-name><ce:surname>Coutu</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>John TY</ce:given-name><ce:surname>Hii</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>David</ce:given-name><ce:surname>Radzik</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Linda</ce:given-name><ce:surname>Lavoie</ce:surname><ce:degrees>BSc</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="AFF1"><ce:label>a</ce:label><ce:textfn>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</ce:textfn></ce:affiliation><ce:affiliation id="AFF2"><ce:label>b</ce:label><ce:textfn>From the Department of Pediatrics, Hôpital Ste-Justine, Montreal, Quebec, Canada</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>∗</ce:label><ce:text>Address for reprints: Robert Lemery, MD, Cardiovascular Consultants, Mid-America Heart Institute, 4330 Wornall, Suite 2000, Kansas City, Missouri 64111.</ce:text></ce:correspondence></ce:author-group><ce:date-received day="9" month="3" year="1993"></ce:date-received><ce:date-revised day="10" month="7" year="1993"></ce:date-revised><ce:date-accepted day="13" month="7" year="1993"></ce:date-accepted><ce:abstract class="author"><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para view="all" id="simple-para.0010">Percutaneous ablation of accessory pathways was performed in 22 consecutive children and adolescents (9 boys and 13 girls, age range 8 to 18 years). Low-energy direct current (DC) was used exclusively in the first 6 patients, whereas ablation was performed with radiofrequency energy in the following 16. Accessory pathways were located in the left free wall in 15 patients, were posteroseptal in 3, were in the right free wall in 3 and were anteroseptal in 1. A concealed accessory pathway was present in 7 patients (32%). There was no significant difference in clinical or electrophysiologic variables between both groups. Catheter ablation was successful in the initial 6 patients using low-energy DC, as compared with 13 of 16 patients using radiofrequency ablation. Low-energy DC was successful as a backup power source in all 3 patients who had unsuccessful radiofrequency ablation. There was no complication. The median procedural and fluoroscopic times for successful ablation were 2.5 hours and 49 minutes, respectively (p = NS between both power sources). Accessory pathway conduction recurred in 2 patients (33%) who had low-energy DC as compared with 1 (6%) who had radiofrequency ablation (p = NS). These 3 patients had successful reablation of their accessory pathways. In children and adolescents with accessory pathways, both new power sources compare favorably, with an overall success rate of ablation of 100% (22 of 22 patients). Radiofrequency ablation should be used initially because it does not require general anesthesia and is associated with a lower rate of recurrence of accessory pathway conduction. Low-energy DC may be most useful as a backup in patients who initially have unsuccessful radiofrequency ablation.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Catheter ablation using radiofrequency or low-energy direct current in pediatric patients with the Wolff-Parkinson-White syndrome</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Catheter ablation using radiofrequency or low-energy direct current in pediatric patients with the Wolff-Parkinson-White syndrome</title></titleInfo><name type="personal"><namePart type="given">Robert</namePart><namePart type="family">Lemery</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation><description>Address for reprints: Robert Lemery, MD, Cardiovascular Consultants, Mid-America Heart Institute, 4330 Wornall, Suite 2000, Kansas City, Missouri 64111.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mario</namePart><namePart type="family">Talajic</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Denis</namePart><namePart type="family">Roy</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Anne</namePart><namePart type="family">Fournier</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Benoit</namePart><namePart type="family">Coutu</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">John TY</namePart><namePart type="family">Hii</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">David</namePart><namePart type="family">Radzik</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Linda</namePart><namePart type="family">Lavoie</namePart><namePart type="termsOfAddress">BSc</namePart><affiliation>From the Department of Medicine, Montreal Heart Institute, Montreal, Canada</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">1993</dateIssued><dateValid encoding="w3cdtf">1993-07-13</dateValid><dateModified encoding="w3cdtf">1993-07-10</dateModified><copyrightDate encoding="w3cdtf">1994</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">Percutaneous ablation of accessory pathways was performed in 22 consecutive children and adolescents (9 boys and 13 girls, age range 8 to 18 years). Low-energy direct current (DC) was used exclusively in the first 6 patients, whereas ablation was performed with radiofrequency energy in the following 16. Accessory pathways were located in the left free wall in 15 patients, were posteroseptal in 3, were in the right free wall in 3 and were anteroseptal in 1. A concealed accessory pathway was present in 7 patients (32%). There was no significant difference in clinical or electrophysiologic variables between both groups. Catheter ablation was successful in the initial 6 patients using low-energy DC, as compared with 13 of 16 patients using radiofrequency ablation. Low-energy DC was successful as a backup power source in all 3 patients who had unsuccessful radiofrequency ablation. There was no complication. The median procedural and fluoroscopic times for successful ablation were 2.5 hours and 49 minutes, respectively (p = NS between both power sources). Accessory pathway conduction recurred in 2 patients (33%) who had low-energy DC as compared with 1 (6%) who had radiofrequency ablation (p = NS). These 3 patients had successful reablation of their accessory pathways. In children and adolescents with accessory pathways, both new power sources compare favorably, with an overall success rate of ablation of 100% (22 of 22 patients). Radiofrequency ablation should be used initially because it does not require general anesthesia and is associated with a lower rate of recurrence of accessory pathway conduction. Low-energy DC may be most useful as a backup in patients who initially have unsuccessful radiofrequency ablation.</abstract><subject><genre>Article category</genre><topic>Congenital heart disease</topic></subject><relatedItem type="host"><titleInfo><title>The American Journal of Cardiology</title></titleInfo><titleInfo type="abbreviated"><title>AJC</title></titleInfo><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">19940115</dateIssued></originInfo><identifier type="ISSN">0002-9149</identifier><identifier type="PII">S0002-9149(00)X0654-6</identifier><part><date>19940115</date><detail type="volume"><number>73</number><caption>vol.</caption></detail><detail type="issue"><number>2</number><caption>no.</caption></detail><extent unit="issue pages"><start>A3</start><end>A22</end></extent><extent unit="issue pages"><start>A33</start><end>A40</end></extent><extent unit="issue pages"><start>103</start><end>212</end></extent><extent unit="pages"><start>191</start><end>194</end></extent></part></relatedItem><identifier type="istex">E2D7375BC26AFD449FEE9E2BC93CA9F1A965052B</identifier><identifier type="DOI">10.1016/0002-9149(94)90213-5</identifier><identifier type="PII">0002-9149(94)90213-5</identifier><identifier type="ArticleID">94902135</identifier><recordInfo><recordContentSource>ELSEVIER</recordContentSource></recordInfo></mods></metadata><enrichments><istex:refBibTEI uri="https://api.istex.fr/document/E2D7375BC26AFD449FEE9E2BC93CA9F1A965052B/enrichments/refBib"><teiHeader></teiHeader><text><front></front><body></body><back><listBibl><biblStruct><analytic><title level="a" type="main">Radiofrequency32-36 energy produces lesions through resistive heating, and general anesthesia is not necessary. 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