Radiofrequency catheter ablation for the treatment of idiopathic ventricular arrhythmia in children : single center experience

  • Yoko Yoshida, Japan
  • Hitoshi Nisida, Department of pediatrics, Kitano hospital, Osaka, Japan
  • Noriyasu Ozaki, Department of pediatric cardiology, Japanese Red Cross Society Wakayama medical center, Wakayama, Japan
  • Jun Yoshimoto, Department of pediatric cardiology, Japanese Red Cross Society Wakayama medical center, Wakayama, Japan
  • Hitoo Fukuhara, Department of pediatric cardiology, Japanese Red Cross Society Wakayama medical center, Wakayama, Japan
  • Keiko Toyohara, Department of pediatric cardiology, Japanese Red Cross Society Wakayama medical center, Wakayama, Japan
  • Ken Watanabe, Department of pediatrics, Kitano hospital, Osaka, Japan
  • Yoshihide Nakamura, Department of pediatric cardiology, Japanese Red Cross Society Wakayama medical center, Wakayama, Japan

    • INTRODUCTION:Idiopathic ventricular arrhythmia is rare in children. Treatment by radiofrequency catheter ablation (CA) is being applied; however, limited data exist regarding the outcome in such patients.

    Purpose:To review the clinical picture and evaluate the efficacy and safety, we report a single center's experience with CA for the treatment of idiopathic ventricular ablation in children.

    METHODS and RESULTS:The subjects were 37 pediatric patients with idiopathic ventricular arrhythmia. The median age at CA was 12.4 years (range 2.2-16.6). Sustained ventricular tachycardia was observed in 9(24%), non-sustained ventricular tachycardia in 22(59%), and premature ventricular contractions in 6(16%). Initially 22 received antiarrhythmic drugs and in 31 exercise was restricted. Nine had symptoms, syncope or heart failure was in 4. Serum brain natriuretic peptide was elevated (>20pg/ml) in 15. Thirty six patients underwent CA and 41 sites of origin were detected, specifically, in the right outflow 22(54%), right inflow 4(9.8%), right epicardium 1(2.4%), Tricuspid annulus 1(2.4%), pulmonary artery 1(2.4%), left ventricular septum 5(12%), left epicardium 4(9.8%), and the left outflow 3(7.1%). The acute success rate was 28/36(78%). CRBBB occurred in 2 patients. After 3 months 29 patients were evaluated by Holtor ECG. Complete success was noted in 19, partial effect in 3, recurrence in 4, and no change in 3. Of the 35 patients followed up more than 3months, 32 were free of drugs and 30 were free of exercise restriction.

    CONCLUSIONS: CA is a safe and effective therapy for pediatric idiopathic ventricular arrhythmia and enables patients to live an active social and physical life.