Introduction: The Quebec Heart and Lung Institute serves more than 2 million people and represents the only electrophysiologic (EP) center for both children and adults in this population. The purpose of this study was to evaluate our experience with catheter ablation in children over a 20-year period.
Results: From 1993 to 2013, 649 EP procedures (85% with ablation) were performed in 591 children with a mean age of 13.3±3.6 years (range 9 months to 17.9 years). Catheter ablation of all AVNRT (n=179) was performed using radiofrequency with recurrence in only 4 patients and no permanent AV block. Concealed or manifest accessory pathways (PW) were documented in 289 procedures.
Recently, in selected postero-septal PW, irrigated catheters have decreased recurrences and failed procedures. There were no major complications including death, AV block, stroke, and tamponade over the whole 20-year period.
Conclusions: Catheter ablation has dramatically improved the natural history of arrhythmia in children as long-term elimination of arrhythmia is obtained in most. New technologies (irrigated catheters, cryotherapy, 3D mapping) have provided additional safety and efficacy to septal pathways and flutter ablation.