Ablation of Accessory Pathways in the Coronary Venous System in Patients ≤18 Years

Background: An accessory atrioventricular pathway (AP) is the most common tachycardia substrate for supraventricular tachycardia (SVT) in the young. Endocardial catheter ablation of posterior septal AP is unsuccessful in 5% of cases due to an epicardial location. Ablation to these pathways may be accomplished within the coronary venous system (CVS). Data of AP ablation within the CVS in the young is sparse. We analyzed feasibility, outcome, and safety in all patients ≤18 years of age with epicardial AP and ablation via CVS in our tertiary pediatric referral center. Results were compared with patients who had endocardial AP ablation from the European Multicenter Pediatric Ablation Registry “EUROPA.”