Definitive therapy of supraventricular tachycardia using high frequency current catheter ablation

Background: Catheter ablation using radiofrequency current has been proven to be an effective and save tool for the treatment of adult patients with accessory atrioventricular pathways and with atrioventricular nodal reentry tachycardia. This study was designed to analyse the efficacy of this method in children and adolescents.

Methods: Using radiofrequency current, catheter ablation of an accessory pathway or of AV nodal reentry tachycardia was performed in 13 patients (mean age 12.7 years) with drug-refractory supraventricular tachycardia. Radiofrequency current was applied through a 6 French steerable catheter positioned against the mitral or tricuspid anulus. Criteria for radiofrequency current application (at 70 degrees C or with 30 W) were the recording of an accessory pathway potential or a local atrioventricular interval < 40 ms. In the patient with atrioventricular nodal reentry tachycardia, a potential of the slow pathway was recorded.

Results: In 6 of 7 patients with left-sided accessory pathways and in 4 of 5 patients with right-sided connections, conduction over these pathways was permanently interrupted. In the patient with atrioventricular nodal reentry tachycardia, radiofrequency current eliminated the tachycardia without affecting normal atrioventricular nodal conduction. In a patient with an anteroseptal pathway, induction of atrioventricular block was inevitable. No other complications were noted.

Conclusions: Catheter ablation using radiofrequency current is a highly effective method for definite treatment of supraventricular tachycardia in children and adolescents.