Radiofrequency Ablation of Accessory Pathways in Children with Complex Congenital Cardiac Lesions: A Report of Three Cases
A 14-year-old boy, weighing 42 kg, presented with recurrent drug (Propranolol and later Amiodarone) refractory tachycardia. Resting electrocardiogram was normal. In the past, he had been diagnosed to have situs inversus totalis with dextrocardia, common atrioventricular canal, and pulmonary stenosis, for which extracardiac total cavopulmonary connection was performed (). Orthodromic atrioventricular reentrant tachycardia was documented (), and the retrograde aortic approach was selected (). The AP was localized to the right posterior region of the common atrioventricular valve. Ablation was successfully performed under ventricular pacing (). The procedure lasted for 60 minutes, and the fluoroscopy time was 12 minutes.\nIn all the cases, the AP was ablated on the atrial aspect of the annulus, using Stinger M, curve D, 7F, 4-mm tip catheters (C.R. Bard, Inc., MA, USA) with a power of 20– 30 Watts in the first case and 40 Watts in the others, and a temperature of 55– 60 °C. The patients were observed for 15 minutes after ablation, and electrophysiological studies were repeated to confirm the abolition of the recurrence of the substrate. Amiodarone was discontinued in the third patient.