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Initial experience of catheter ablation for cardiac arrhythmias in children and adolescents at a newly built ablation centre.

Initial experience of catheter ablation for cardiac arrhythmias in children and adolescents at a newly built ablation centre.
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Pietrzak R, Lodziński P, Książczyk T, Balsam P, Gawałko M, Opolski G, Werner BB,


Pietrzak R, Lodziński P, Książczyk T, Balsam P, Gawałko M, Opolski G, Werner BB, (click to view)

Pietrzak R, Lodziński P, Książczyk T, Balsam P, Gawałko M, Opolski G, Werner BB,

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Kardiologia polska 2017 08 23() doi 10.5603/KP.a2017.0166
Abstract
BACKGROUND
Catheter ablation (CA) therapy is the first choice treatment in adults with heart rhythm disturbances. The arrhythmias in adults are mainly conditioned by coronary disease. Etiology of arrhythmias in children is mostly associated with inherited heart disorders. According to the current guidelines the CA is widely used in children, indicating the need to make it more achievable in pediatric population.

AIM
To assess efficacy and safety of CA in children with different types of arrhythmias on the initial learning curve at newly built Ablation Center in The Independent Pediatric Hospital of Medical University of Warsaw.

METHODS
The study population consisted of 32 children with supraventricular tachycardias, asymptomatic pre-excitation syndrome or ventricular ectopic beats undergoing CA. The mean age of study population was 14.1±2.4 years. In all patients, electrophysiological study (EPS) and CA was performed. Analysis with respect to procedure duration, fluoroscopy exposure duration, location of accessory pathways (AP), success rate, recurrences and complications was performed.

RESULTS
The mean procedure duration was 105.4±41.4 minutes (range 40-175 minutes). The mean fluoroscopy duration was 8:34±5:01 minutes (range 1:28-21:01). The mean exposure to ionizing radiation was 4.7±3.2 mcG/kg. EPS revealed significantly more frequent presence of AP in the left side (57.1%). The RF ablation procedure was successful in 26 of 32 (81.3%) children and cryoablation was successful in 2 of 4 patients. In two children (6.3%) minor complications occurred.

CONCLUSIONS
Catheter ablation may be effectively performed without major complications in the initial phase of the learning curve if a reasonable approach with a gradual increase of the procedural complexity is taken.

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