Ablation of Tachyarrhythmia in Small Children Under One Year Old

The aim of the study was to evaluate the safety and efficacy of RFA in critically ill small children (< 1 year of age) with drug resistant tachycardia accompanied by arrhythmogenic cardiomyopathy and heart failure.

Material: The study included 25 patients aged 5.1 ± 3.6 months. Wolff-Parkinson-White syndrome and atrial tachycardia were detected in sixteen (60 %) and ten (40 %) patients, respectively. Patients with structural heart pathology, including congenital heart diseases and laboratory-confirmed myocarditis, were excluded from the study.

Results: The indication for RFA was drag refractory supraventricular tachycardia (SVT) accompanied by arrhythmogenic cardiomyopathy and heart failure. Unsuccessful ablation was observed in two 1-month-old patients who underwent successful ablation 3 months later. The follow-up periods ranged from 0.3 to 10 years (average 5.2 years). Only two patients (10%) had tachycardia recurrence 1 and 2 months after RFA, respectively. The RFA success rate was 92%. The study did not show any procedure-related complications. Heart failure disappeared within 5–7 days after RFA. Complete normalization of cardiac chambers sizes was documented within 1 month after effective RFA. A three-dimensional CARTO system was used in three patients with body weight > 7 kg. The use of the CARTO system resulted in a remarkable decrease of the fluoroscopy time without vascular injury or other procedure-related complications in all cases.

Conclusions: Our study suggested that RFA may be considered as the method of choice for SVT treatment in small children when drug therapy is ineffective and arrhythmogenic cardiomyopathy progresses.