Pediatric electrophysiology
DOI:
https://doi.org/10.13112/pc.1084Keywords:
ELECTROPHYSIOLOGY; HEART; CHILD; ARRHYTHMIAS, CARDIACAbstract
Electrophysiology has emerged as an important diagnostic and therapeutic method in the last three decades, often the first choice in the treatment of arrhythmias. In this procedure, catheter electrodes are used to enter the heart through central veins or arteries to determine the exact arrhythmogenic substrate and often to interrupt its activity by ablation.
The greatest step forward in reducing the amount of ionizing radiation in these procedures was the introduction of 3D mapping systems. These systems allow for the spatial placement of the catheter and the creation of a map of the heart's anatomy and electrical activity. The intracardiac electrogram is saved and the activation time can be compared with a reference point. It allows for the creation of an activation map that shows the way the signal propagates through the heart, which increases the precision of the work compared to procedures performed exclusively using X-ray radiation. This significantly reduces the patient's radiation exposure, which is especially important in childhood.
In Croatia, more than 2000 electrophysiological procedures are performed annually in all age groups, and almost 300.000 in Europe. In children, there were slightly more than 100 electrophysiological procedures performed in 2024. in our country.
This method of treatment achieves a permanent cure for arrhythmia, which is its greatest advantage compared to the only other option, drug treatment. While the effects of drugs are seen when patients take them regularly, there are no drugs that can definitively cure an arrhythmia. Since long-term use of drugs that have significant side effects is required, it is clear why electrophysiology, despite its risks, is increasingly used as the first line of treatment.
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