The Use of Radiofrequency Energy in Pediatric Cardiology

The use of radiofrequency energy for the treatment of supraventricular tachycardia in pediatric patients has gained widespread acceptance, especially.for tachyarrhythrriias associated with pulpitutions, dizziness, presyncope or syncope. cardiomyopathy, and cardiac arrest. Ablation of the substrate supporting atrioventricular reentry, atrioventricular node reentry, and automatic atrial tarhyrardici yields a 90%-98 % success rate with low incidence [ < 1 %) of complications and adverse side-effects. Ablation of intra-atrial reentry, including atrial flutter and jYbrillation. appears to be promising and would be a significant udvanee in the management of putients following extensive atrial surgery for congenital heart disease. Radiofrequency energy is also used to treat various forms of idioputhic ventricular tachycardia. Finally, radiofrequency energy has been extended to control the ventricular rate associated with malignant atrial tachycardia by either mod$ication or ablation ofthe atrioventricular node, and suhsrquent pacemaker implant. Long-term outcome of radiofrequency trblution is unknown, but the short-to-intermediate ( 1-5 yrs) outconie is excellent, with low recurrence rate of thc tachycardia, no proarrhythmic effect, and excellent clinical state. (J Interven Cardiol I995;8:557-568