The Journal of Innovations in Cardiac Rhythm Management | 2019
Small Size, No versus Limited Fluoroscopy, and Other Challenges of Pediatric Ablation Procedures
Abstract
The author reports no conflicts of interest for the published content. Address correspondence to: Kathryn K. Collins, MD, Division of Pediatric Cardiology, Children’s Hospital Colorado, 13123 East 16th Avenue, Aurora, CO 80045, USA. Email: [email protected]. Catheter ablation for the management of arrhythmia substrates has been available as a treatment option for almost 30 years. Over that time, significant technological efforts have been made in electroanatomic systems to decrease fluoroscopy exposure, improve mapping of the arrhythmia substrate, and refine the delivery of ablative energy (be it cryoablative energy or radiofrequency energy). In the current issue of the Journal of Innovations in Cardiac Rhythm Management, Dr. Chang1 presents a complex case study of an infant who underwent catheter ablation for ectopic atrial tachycardia in a manner that serves to highlight some of the challenges that persist regarding conducting ablations in the very young. In this supplementary commentary, I would like to highlight three key aspects that must be carefully kept in mind in pediatric patients undergoing such procedures, as follows: patient size, the use of no versus limited fluoroscopy, and maintaining limited vascular access.