Radiofrequency Catheter Ablation in Pediatrics: Expe-
rience at Siriraj Hospital
JARUPIM SOONGSWANG, M.D.*,
ONGKARN RAUNGRATANAAMPORN, M.D.**,
RUNGROJ KRITTA YAPHONG, M.D.***,
CHARUWAN KANGKAGATE, B.Sc., M.S.(Biostat)**,
ANNA CHIRAPASTAN, B.Sc.(Nursing)**
KIERTIJAI BHURIPANYO, M.D.**,
CHARN SRIRATANASATHAVORN,M.D.**,
THITIMA NUTAKUL, M.D.****,
SUKANY A POORANA WATT ANAKUL, B.Ed. **
Affiliation : * Division of Cardiology, Department of Pediatrics,
** Her Majesty Cardiac Center,
*** Division of Cardiology, Department of Medicine,
**** Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
AbstractTachyarrhythmia is one of the life threatening cardiac electrophysiology problems in
children. It also affects quality of life of the patients. Radiofrequency catheter ablation (RFCA) has
made a significant impact in the treatment of tachyarrhythmia since 1989. The present report is the
first and largest report in Thai children. There have been 24 RFCA procedures in 21 children since
it was initially performed at Siriraj Hospital from January 1996 to December 1999. The electro-
physiology studies and medical records were analyzed retrospectively. Median age and weight at the
time of the procedure were 11 (1.1-13) years old and 38.8 (6.8-78.2) kg respectively. The presenting
symptoms were palpitation 66.7 per cent, presyncope 16.7 per cent, congestive heart failure and
cardiogenic shock 8.3 per cent, syncope 4.2 per cent, and chest pain 4.2 per cent. Median duration of
symptom was 3.5 (0.1-8.0) years. The underlying cardiac arrhythmias were Wolff Parkinson White
(WPW) syndrome 50 per cent, concealed accessory pathway 16.7 per cent, atrioventricular node
re-entry tachycardia (A VNRT) 16.7 per cent, atrial ectopic tachycardia (AET) 12.5 per cent, and
WPW with A VNRT 4.2 per cent. The median fluoroscopy time and procedure time were 25 ( 4-145)
minutes and 125 (60-320) minutes respectively. The median tachycardia cycle length was 332.5
(220-460) seconds. The immediate success rate was 21/24 (87 .5%) procedures. The procedural
complication was 1/24 (4.2%). Two patients (8.3%) had recurrences of tachycardia and were suc-
cessfully controlled with antiarrhythmic drugs.
Conclusion : RFCA is a safe, effective, and curative procedure with high success rate for
pediatric tachyarrhythmias.
Keywords : Radiofrequency Catheter Ablation, Tachyarrhythmia, Supraventricular Tachycardia
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