Methods: A retrospective analysis of all patients undergoing EP study and ablation at the Children’s Hospital of Montefiore from 2008-20011 for SVT and/or WPW was performed. All patients less than 21 years of age who underwent ablation from the RIJV for either WPW or a concealed accessory pathway located in the anteroseptal region were included. Demographics, EP study and ablation data, and follow-up data were recorded.
Results: A total of 182 patients underwent EP study and ablation for WPW or a concealed AP during the study period and there were 16 patients who met inclusion criteria and were the subject of this analysis. The mean age was 15 ± 4 years and weight was 58 ± 16 kg. 12 patients had WPW (75%) and 4 had a concealed AP (25%). Ablation was acutely successful in 94% of patients (15/16). In one patient, ablation was deferred due to close proximity to the compact AV node and risk of AV nodal injury. Radiofrequency (RF) was used in 14 patients and cryoenergy in 2 patients. In the RF patients, the mean number of lesions required for a successful ablation was 1.9 ± 0.9 and the mean time to loss of AP conduction was 0.8 ± 0.8 sec. There was no difference in WB CL pre or post ablation (p= 0.19). There were no complications encountered. At a mean follow-up of 15 ± 12 months there were no recurrences.
Conclusion: Ablation of APs in the right anteroseptal region can safely and effectively be performed via the RIJV with a success rate of 94%. This technique should be considered for ablation of AP’s located in the anterior septum.