Radiofrequency Catheter Ablation of Accessory Atrioventricular Pathways in Infants and Toddlers a parts per thousand currency sign 15 kg

Accessory atrioventricular pathways (AP) are the most common substrate for paroxysmal supraventricular tachycardia in infants and small children. Up-to-date data on AP ablation in infants and small children are limited. The aim of the present study was to gain additional insight into radiofrequency (RF) catheter ablation of AP in infants and toddlers focusing on efficacy and safety in patients with a body weight of a parts per thousand currency sign 15 kg. Since 10/2002, RF ablation of AP was performed in 281 children in our institution. Indications, procedural data as well as success and complication rates in children with a body weight a parts per thousand currency sign 15 kg (n = 22) were compared with children > 15 kg (n = 259). Prevalence of structural heart anomalies was significantly higher among children a parts per thousand currency sign 15 kg (27 vs. 5.7 %; p = 0.001). Procedure duration (median 262 vs. 177 min; p = 0.001) and fluoroscopy time (median 20.6 vs. 14.0 min; p = 0.007) were significantly longer among patients a parts per thousand currency sign 15 kg. Procedural success rate did not differ significantly between the two groups (82 vs. 90 %). More RF lesions were required for AP ablation in the smaller patients (median 12 vs. 7; p = 0.019). Major complication rate was significantly higher in children a parts per thousand currency sign 15 kg (9 vs. 1.1 %; p = 0.05) with femoral vessel occlusion being the only major adverse event in patients a parts per thousand currency sign 15 kg. Catheter ablation of AP in children was effective irrespective of body weight. In children a parts per thousand currency sign 15 kg, however, procedures were more challenging and time-consuming. Complication rate and number of RF lesions in smaller children were higher when compared to older children.