Radiofrequency catheter ablation (RFCA) has become an effective therapeutic modality for treating pediatric tachyarrhythmias. Using conventional RFCA catheters, ablation of parahisian accessory pathways may be difficult and have high risk for heart block. We reviewed the efficacy and complications of the RFCA in children and adolescent with arrhythmias including parahisian accessory pathways.

We studied 48 patients (aged 2 years to 20 years) who had undergone RFCA from August 2003 to March 2007. We reviewed clinical findings, electrophysiologic studies, RFCA data, complications, and follow-up results of the patients.

Mean age of the patients was 13.1 years. Numbers and types of arrhythmias (age, acute success rate) were as follows: 19 WPW syndrome including 5 parahisian accessory pathways (13.7±4.6 yr, 18/19), 11 atrioventricular reentrant tachycardia with concealed bypass tract (12.3±5.0 yr, 10/11), 13 atrioventricular nodal reentrant tachycardia (12.6±4.4 yr, 13/13), 4 atrial flutter (13.0±7.4 yr, 3/4), and 1 ventricular tachycardia (20 yr, 1/1). Associated cardiac structural lesion was not detected in 48 patients. The recurrence rate was 6.5%, and the final success rate was 93.8%.

These results suggest that RFCA is a highly effective treatment method in children and adolescent with tachyarrhythmia.