Lack of proarrhythmia as assessed by Holter monitor after atrial radiofrequency ablation of supraventricular tachycardia in children

• Published in: The American heart journal Vol. 132; no. 1; pp. 120 - 124
• Main Authors: Johnson, Thomas B., Varney, Fred L., Gillette, Paul C., McKay, Christine A., Case, Christopher L., Whitsett, Jacquelyn H., Knick, Barbara J.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.07.1996; Elsevier
• Subjects: Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Arrhythmias, Cardiac - diagnosis; Arrhythmias, Cardiac - etiology; Biological and medical sciences; Catheter Ablation; Child; Child, Preschool; Electrocardiography, Ambulatory; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Follow-Up Studies; Heart Atria - physiopathology; Heart Atria - surgery; Humans; Infant; Intensive care medicine; Medical sciences; Recurrence; Retrospective Studies; Risk Factors; Tachycardia, Supraventricular - diagnosis; Tachycardia, Supraventricular - etiology; Tachycardia, Supraventricular - surgery; Tachycardia, Ventricular - diagnosis; Tachycardia, Ventricular - etiology; Ventricular Premature Complexes - diagnosis; Ventricular Premature Complexes - etiology; Human; Holter recording; Prognosis; Arrhythmia; Cardiovascular disease; Paroxysmal supraventricular tachycardia; Radiofrequency; Excitability disorder; Percutaneous route; Electrodiagnosis; Treatment; Electrotherapy; Heart disease; Child
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/S0002-8703(96)90399-3

The purpose of this study was to assess the short-term arrhythmogenicity of atrial radiofrequency (RF) ablation lesions in children. Patients with the greatest exposure to RF energy comprised the study group. Holter data on 35 RF ablation procedures in 31 patients with a median age of 13.2 years (range 3 months to 20 years) was retrospectively analyzed. Patients received an average of 19.9 (SD = 13.6) RF lesions, all delivered by an atrial approach. Supraventricular ectopy and ventricular ectopy were compared immediately before and after and 4 to 9 weeks after RF ablation by serial Holter monitoring. Factors thought to possibly predispose patients to a proarrhythmic effect were used to define subgroups for separate analysis. No increase in ambient supraventricular ectopy or ventricular ectopy was observed either immediately after or 4 to 9 weeks after RF ablation compared with the baseline Holter recordings. Children exposed to relatively large doses of RF energy may demonstrate transient and asymptomatic nonsustained tachycardias in the short term. However, no new sustained tachycardias and no increase in supraventricular or ventricular ambient ectopy are detected by short-term Holter monitoring.