Ten-year Experience of Radiofrequency Catheter Ablation of Accessory Pathways in Children and Young Adults

Transcatheter radiofrequency ablation of supraventricular tachycardia was first introduced in 1987. The procedure is now well-accepted as primary treatment for supraventricular tachycardia in paediatric patients. In this report we describe our experience of radiofrequency ablation of accessory pathway mediated supraventricular tachycardia in the past 10 years. From 1994 to 2005, 121 procedures of radiofrequency ablation of accessory pathway were performed on 103 children and young adults aged 4.3 to 24.7 years. Ninety-three patients (90.3%) had one pathway and 10 (9.7%) had 2 pathways. Forty-four percent of all accessory pathways were associated with Wolff-Parkinson-White syndrome. There were 73 (65.2%) left- sided accessory pathways and 39 (34.8%) right-sided accessory pathways. One hundred and three (92%) accessory pathways were successfully ablated. Successful rate of left-sided accessory pathway ablation was higher than the right-sided accessory pathway (97.3% vs. 82.1%, p=0.005). Two patients (1.9%) developed major complications: one transient second degree and one permanent complete heart block who required permanent pacing. Recurrence after first successful radiofrequency ablation was 10.4% (9/86). Seventeen procedures (14%) were performed for failed first radiofrequency ablation or recurrence. On follow-up 90.3% of all patients remained asymptomatic. Our experience indicated that radiofrequency ablation is a safe and effective treatment for accessory pathway mediated supraventricular tachycardia in children and young adults.