Ablation in Pediatric Patients and in Association with Congenital Heart Disease

摘要

Transcatheter ablation (TA) for treatment of pediatric tachyarrhythmias was first introduced in the early 1990s. Since then, its use as an alternative to antiarrhythmic drugs to treat supraventricular tachycardias (SVTs) caused by accessory pathway (AP) has been gradually increasing, to the point that nowadays TA can be performed with high success rates and low complication rates. Moreover, recently, the use of different types of energy (radiofrequency RF and cryoenergy), special ablation catheters, and 3-dimensional (3D) nonfluoroscopic mapping systems equipped with high technological tools have further improved safety and efficacy of TA, especially in difficult substrates and in patients with congenital heart disease (CHD). Regarding small children (<5 years or 15 kg) and infants, current results seem to be encouraging supporting the routine use of this interventional approach. However, further studies and longer follow-up are needed to understand the risk/ benefit ratio, and, for this reason, this population deserves a distinct discussion.