Viera Illíková, Peter Hlivák, Robert Hatala
Catheter ablations have changed dramatically the management of tachycardias both in adults and in children. This article characterizes the present role of radiofrequency catheter ablation in children, its efficacy, safety and indication criteria. Accessory and dual atrioventricular (AV) pathways, which are the prerequisite of accessory pathway-mediated tachycardia and AV nodal reentry tachycardia, are the most frequent arrythmogenic substrates for ablation. Data from the international Paediatric Ablation Register showed high success rate and low complication risk of ablations in children and they had consistently demonstrated that benefits outweigh the risks of the ablation procedure in children with the age above 4-6 years or weight above 15-20 kg. Indications for ablation in children are intended as a general framework for decision-making and do not replace the need for highly individualized clinical judgment in an individual patient.