Akademik Veri Yönetim Sistemi
AEPC 2022 - 55th Annual Meeting of the Association for European Paediatric and Congenital Cardiology , Geneve, İsviçre, 25 - 28 Mayıs 2022, ss.483-484
BACKGROUND AND AIM: The purpose of this study was to evaluate arrhythmia substrates,
outcomes,and complications of catheter ablation using a three-dimensional (3D) electroanatomical
mapping system in children with congenital heart disease (CHD).
METHODS: The medical records and procedural data of patients with CHD who underwent invasive
electrophysiological study (EPS) and catheter ablation between November 2013 and 2021 were
evaluated.Clinical characteristics,echocardiographic examination,ablation procedures,outcomes and
follow-up were obtained from hospital records using the Filemaker database.EPS were performed
using the EnSite™system (St Jude/Abbott Medical, St Paul, MN, USA)with limited fluoroscopy.
RESULTS: 132 patients(73 males, 55.3%) with CHD and treated with catheter ablation were
evaluated retrospectively.The mean age was 14.5±7.8 years (range, 2-43 years) and the mean weight
was 47.3±20.4kg (range,11-98 kg).The most common diagnoses were Ebstein’s anomaly (n:32),atrial
septal defect(n:25),ventricular septal defekt(n:16),tetralogy of fallot (n:21),single ventricle (n:7) and
transposition of great arteries (n:5). 72(54.5 %) patients had undergone prior corrective or palliative
cardiac surgery. Arrhythmia mechanisms included Wolff- Parkinson-White syndrome (n:41; 28%),
intra atrial reentran tachycardia (IART, n:30; 20.5%), atrioventricular nodal reentry tachycardia
(AVNRT, n:29; 19.8%), focal atrial tachycardia (FAT, n:14; 9.5%), PVC (n:13; 8.9%), AVRT due to
concealed accessory pathway (n:11; 7.5%), ventricular tachycardia (n:2; 1.3%) and others (n:6; 4.1%).
Of the 132 procedures, 45 (34%) were radiofrequency ablations,33 (25%) were irrigated
radiofrequency ablations and 26 (%19,6) were cryoablation.Both non irrigated and irrigated
radiofrequency ablation were used in 21(15.9%) and radiofrequency ablation and cryoablation were
used in eight (6%) procedures.The mean procedure time was 178.4±70.6 minutes.Fluoroscopy was
used in 78 (%59) patients.The mean floroscopy time was 5.2 ± 7.8 minutes.Procedural success was
complete in 92.4% (n=122) and partial in 5.3% (n=7) of patients,whereas ablation failed in 7%
(n=2.3).During a mean follow-up period of 38.1 ± 24.9 months 12 patients had recurrence
(%9.8).Except for two, the procedure was successful with the second ablation performed in the
others.No major complications were observed,except for the patient who underwent balloon angioplasty after narrowing of the Cx during the procedure.
CONCLUSIONS: Despite the complex anatomy,age,and limited vascular intervention possibilities in
patients with CHD,transcatheter ablation treatment with 3-D electroanatomical mapping and limited
fluoroscopy seems to be a safe and effective option.