Pediatrics Medical News about radiofrequency ablation, supraventricular tachycardia, atrial tachycardia

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Radiofrequency ablation of nonautomatic focal atrial tachycardia in children with structurally normal hearts
Journal of Interventional Cardiac Electrophysiology , 08/19/09

Moltedo JM et al. – Nonautomatic focal atrial tachycardia (NAFAT) is a rare form of tachycardia to be considered in the differential diagnosis of children presenting with supraventricular tachycardia (SVT). NAFAT is amenable to mapping and radiofrequency ablation.

Methods

Report of an unusual mechanism of SVT in children with structurally normal hearts
Record review for all electrophysiology study (EPS) pts between 2000-2004 to identify pts with NAFAT

Results

Identification of 5 pts (3 males); average age of 13.8 yrs (median 15 yrs, range 7–18 yrs)
Presentation: paroxysmal palpitations and structurally normal hearts for all pts
At EPS, SVT reproducibly induced with programmed atrial stimulation (single, double, or triple extra-stimuli) in all pts
Average cycle length: 276+/- 9 ms
Adenosine terminated SVT in 2
3D-electro-anatomical system mapping in all cases
Right atrium (RA) mapped in all pts and the left in 2 pts
Foci mapped to posterior high RA, lateral RA, lower mid RA septum, inferior to sinus node, and in right and left posteroseptal areas
Average number of radiofrequency lesions placed: 8.6 +/-5
Success rate: 80%, with 1 late recurrence
No procedural complications reported