Katheterablatie met radiofrequente energie ter behandeling van kinderen met hartritmestoornissen: gunstige resultaten na gemiddeld 4 jaar

Analysis of long-term results with radiofrequency catheter ablation (RF ablation) in children.

Design

Retrospective.

Method

Data were analysed from all 118 paediatric patients ≤ 18 years old who underwent RF ablation at the Leiden University Medical Centre (LUMC), the Netherlands, during the period 1 December 1992-31 May 2004.

Results

The group consisted of 60 boys and 58 girls with a mean age of 12.7 years (SD: 4.6). They underwent 140 RF ablation procedures for 122 disorders. Indications for RF ablation were: failure or side-effects of antiarrhythmic medication (45), patient/parent choice (45), cardiomyopathy or life-threatening arrhythmia (8), and impending surgery for a congenital heart defect (2). The mean follow-up interval was 4 years (SD: 3.2; range: 1.2 months-11.3 years). The final total success rate for RF was 93 (n = 110). 19 patients (16) underwent a total of 22 repeat procedures. Recurrences occurred after a mean period of 2.3 months (SD: 2.5) following successful RF ablation. Major complications (2nd degree AV block) occurred in 2 patients. During follow-up, no evidence was found of new arrhythmias or of coronary artery lesion development as the result of RF ablation. There was no difference between the < 10 years of age group and the ≥ 10 years of age group in terms of final success rate (93 vs. 93; p = 0.914) and complication rate (3 vs. 7, p = 0.680).

Conclusion

The long-term outcome of paediatric patients who underwent RF ablation was good. RF ablation in young children (< 10 years) was found to be safe and effective. These results demonstrate that it is also possible to curatively treat this group of patients with RF ablation in specialized centres.

Ned Tijdschr Geneeskd 2005;149:1339-46