Efficacy of Radiofrequency Catheter Ablation versus Antiarrhythmic Drugs in Treating High Burden Premature Ventricular Contractions in Children with Structurally Normal Heart

Abstract

This was a prospective, observational study at Electrophysiology Unit-Ain Shams University From October 2018 to September 2020. the study was conducted on 60 child ≤18 years referred to Electrophysiology Unit-Ain Shams University with High burden PVCs (≥10% of total beats per day) that were divided into two groups, each composed of children and of both sexes, referred for possible Electrophysiology study and radiofrequency catheter ablation. We included only children with up to two PVCs morphologies and at least 10% ventricular ectopy burden on a 24-h Holter monitor and structurally normal heart. the study population was divided into group A, in whom antiarrhythmic drugs were offered with strict follow-up and the Electrophysiology study was deferred and Group B, where children ≥ 4 years old in whom Electrophysiology study and radiofrequency catheter ablation was performed if still symptomatic despite at least 3 months duration of AADs or developed adverse effects from AADs and if started to develop PVCs induced cardiomyopathy manifestations, either clinically or via echocardiographic parameters. All selected patients were subjected to baseline full history taking along with full clinical examination, standard or 12-lead Holter recording, and echocardiography were performed. Patients were asked to return for regular follow-up at 3, 6 and 12 months after either RFA or starting AAD. Clinical symptoms were collected. Physical examination, repeat standard ECG, standard or 12-lead Holter recording, and echocardiography were performed.