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      Tachycardias in Infants, Children and Adolescents: Safety and Effectiveness of Radiofrequency Catheter Ablation

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          Abstract

          Radiofrequency catheter ablations provide an effective control of a variety of supraventricular and ventricular tachycardias in adults. This study was designed to evaluate the efficacy and safety of radiofrequency catheter ablations in infants, children and adolescents. Ninty-three ablations were performed in 84 patients ranging from 5 months to 18 years of age. All but 1 patient were successfully treated (98.8%). Two patients required 1 and 2 additional attempts to achieve success. Tachyarrhythmic episodes recurred in 4 patients within 1–5 months after ablation, which were successfully treated by repeating the intervention. Significant complications occurred in 3 of the ablations (3.2%). Although radiofrequency ablations are very effective and safe in pediatric patients, indications should be restricted in patients younger than 4 years because of a higher risk of possibly life-threatening complications.

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          Most cited references 3

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          Permanent junctional re-entry tachycardia. A multicentre long-term follow-up study in infants, children and young adults.

          Permanent junctional re-entry tachycardia is a relatively uncommon form of re-entry tachycardia with antegrade conduction occurring through the atrioventricular node and retrograde conduction over an accessory pathway usually located in the postero-septal region. It was the aim of the study to investigate the course of permanent junctional re-entry tachycardia with particular regard to the effectiveness of pharmacological treatment and ablation procedures; evaluation was performed with respect to the patient's symptoms, tachycardia rate, frequency of the tachycardia and left ventricular function.
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            Transcatheter Radiofrequency Ablation for Congenital Junctional Ectopic Tachycardia in Infancy

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              Incidence of femoral vein occlusion after catheter ablation in children: evaluation with magnetic resonance angiography.

              Catheter ablation in children requires placement of multiple large femoral venous sheaths and catheters. Magnetic resonance angiography (MRA) was used to evaluate the effect of indwelling lines on femoral venous blood flow. Between October 1993 and February 1994 a total of 17 patients scheduled for catheter ablation underwent venous MRA. Two-dimensional time-of-flight MRA was performed 12-70 hours after catheterization on all patients. All patients received intravenous heparin during the procedure and had aspirin therapy instituted after ablation. Eighteen catheter ablations and MRA studies were performed on the 17 patients (one patient underwent repeat ablation). There were 7 females and 10 males, with a mean age of 14.8 +/- 4.2 years (range 8-21 years). Patients had three venous sheaths inserted in the left femoral vein (5F, 6F, and 7F with external diameters measuring 1.7, 2.0, and 2.3 mm, respectively) and one sheath in the right femoral vein (7F). Four patients (22%) had altered venous flow (two complete obstructions and two partial obstructions) following catheterization. None of these patients experienced symptoms or complications. It was concluded that there is an increased incidence (22%) of venous obstruction following catheter ablation, but there are no related complications. Venous MRA provides a rapid, noninvasive method for evaluating venous flow abnormalities and possibly detects patients at risk for complications.
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                Author and article information

                Journal
                CRD
                Cardiology
                10.1159/issn.0008-6312
                Cardiology
                S. Karger AG
                0008-6312
                1421-9751
                2000
                November 2000
                22 November 2000
                : 94
                : 1
                : 44-51
                Affiliations
                Department of Pediatric Cardiology, Heart Center, Gil Medical Center, Gachon Medical School, Inchon, Korea
                Article
                7045 Cardiology 2000;94:44–51
                10.1159/000007045
                11111144
                © 2000 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 1, Tables: 3, References: 32, Pages: 8
                Categories
                Congenital Heart Disease

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