Safety and Efficacy of Open Irrigated-Tip Catheter Ablation of Wolff-Parkinson-White Syndrome in Children and Adolescents
Source of funding: None declared.
Conflict of Interest: Dr. Della Bella is a consultant for St. Jude Medical and has received honoraria for lectures from Biosense Webster, St. Jude Medical, and Biotronik.
Address for reprints: Simone Gulletta, M.D., Department of Cardiology and Cardiothoracic Surgery, Arrhythmia Unit and Electrophysiology Laboratories, Ospedale San Raffaele, via Olgettina 60, Milan, Italy. Fax: 39-02-26437326; e-mail: email@example.com
Irrigated-tip catheter technology has been used for the elimination of resistant accessory pathways (AP) in adults with Wolff-Parkinson-White (WPW) syndrome. However, there are persistent concerns regarding the safety of irrigated catheters in the pediatric population. In this report we present our experience, in terms of effectiveness and safety, of irrigated catheter technology in children and adolescents who underwent ablation of WPW.
We prospectively followed up all patients less than 18 years old (n = 41, mean age of 12.8 years old) who were referred to our center for radiofrequency (RF) catheter ablation of WPW between January 2010 and July 2011. Catheter ablation was performed in all patients using an open irrigated-tip catheter (Celsius Thermocool 3.5 mm, 7F, B-type, Biosense Webster, Diamond Bar, CA, USA). Power was started from 15 W up to 30 W in right-sided AP; RF pulses in left-sided APs were delivered at 40 W while 20 W was delivered inside the coronary sinus.
Mean procedure time was 26.4 minutes and mean fluoroscopy time was 12.2 minutes. Overall procedural success was obtained in 39/41 (95.1%) patients after the first procedure. No complications were observed after the procedure. All patients attended their scheduled follow-up visit at 3, 6, and 12 months and no recurrences were observed based on 12-lead electrocardiogram and 24-hour Holter monitoring.
RF ablation of APs using open irrigated-tip catheters can be performed in children and adolescents with a high acute and long-term success rate, very short procedure times, and acceptable fluoroscopy times.