Cardiac Ablation in the Pediatric Population at a Tertiary Care Center in a Developing Country

Introduction: The aim of this study was to describe our experience and outcome of ablation therapy of arrhythmias in children at a tertiary care center. Methods: Data was collected retrospectively from the hospital medical records. All children presenting to AUBMC between 2000 and 2020 who underwent cardiac ablation were included. The data collected included type of arrhythmia, ablation technique, age and weight at ablation, procedure complications, medications used, and outcome assessment. Results: We had 67 patients who underwent cardiac ablation. Of those, 60% were males with a mean age of 15 years. Structural heart disease was present in 6% of patients. Wolff-Parkinson-White syndrome (WPW) was most prevalent at 31%, followed by atrioventricular nodal reentrant tachycardia (AVNRT) at 24%, atrioventricular reentrant tachycardia (AVRT) at 19%, ventricular tachycardia (VT) at 10%, atrial fibrillation (AF) at 2%, and atrial tachycardia (AT) at 1%. The remaining 13% of patients presented with less common types of arrhythmias, including narrow complex tachycardia, retrograde dual atrioventricular nodal reentry, premature ventricular contractions (PVC), and orthodromic reciprocating tachycardia. Antiarrhythmic medications were started prior to the procedure in 59% of our population. Medication regimens post-ablation included beta blockers (68%), type 1c antiarrhythmics (25%), calcium channel blockers (3%), ivabradine (2%), and amiodarone (2%). The completed procedures showed a success rate of 93%. Conclusion: Ablation of arrhythmias in children is an effective procedure in the treatment of childhood arrhythmias. More studies are needed on cardiac ablation in children with structural heart disease in the Middle East region.