Safety and efficacy of paediatric outpatient radiofrequency catheter ablations.

Aims: Radiofrequency catheter ablation (RFA) is a frequently performed procedure as treatment for supraventricular tachycardia in children >4 years of age. The aim of this study was to evaluate the safety and efficacy of the paediatric outpatient RFA procedure.

Methods: Between 2002 and 2008, 271 RFAs were analyzed. Exclusion criteria for outpatient procedures amongst others were distance to home >1h and anticipated complex RFA in congenital heart disease. All patients underwent pre- and post-procedural echocardiography and electrocardiogram. Patient discharge was within 6h after conclusion of RFA. Parental follow-up phone calls the day after the procedure were performed. All patients were seen in outpatient clinics 1 month after RFA.

Results: A total of 97/271 (37%) patients aged 13.6 (4.8-18.0) years qualified for outpatient RFA. Accessory pathway ablations (n=50) and atrioventricular node modifications (n=39) were the most common RFAs. RFA was successful in 94/97 (97%) patients. Post-procedural echocardiography and electrocardiogram did not reveal any RFA related complications. Anaesthetic adverse events, predominantly post-interventional nausea and vomiting, were observed in 10 (10%) patients. Hospital discharge within 6h was practicable in all but one due to ongoing nausea. Follow-up phone calls did not reveal further complications. Recurrence of tachycardia after successful RFA was observed in 6 of 94 (6%) patients and prompted re-intervention in 4.

Conclusions: Outpatient RFA is feasible and safe in selected paediatric patients. No RFA related complication was observed. Anaesthetic adverse events were nausea and vomiting due to general anaesthesia. Success rate and recurrence rate of tachycardia were favourable after outpatient RFA.