{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T20:30:40Z","timestamp":1784665840316,"version":"3.55.0"},"reference-count":14,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T00:00:00Z","timestamp":1564704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Accessory pathways (APs) are a common reason for supraventricular tachycardia in small children. Trans\u2010septal puncture (TSP) approach is commonly used for the ablation of left\u2010sided APs, however it may be challenging in small children. The aim of this study was to assess the efficacy and safety of trans\u2010septal approach radiofrequency (RF) ablation of left\u2010sided APs in children weighing up to 30\u00a0kg.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Of the 658 children who underwent catheter ablation of APs since 06\/2002, 86 children had left\u2010sided AP and weighed less than 30\u00a0kg. TSP approach guided with TEE and fluoroscopy was used for left atrium access.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age, height, and body weight were 7.6\u00a0\u00b1\u00a01.9\u00a0years, 122.4\u00a0\u00b1\u00a09.3\u00a0cm and 24.0\u00a0\u00b1\u00a04.2\u00a0kg, respectively. Forty\u2010three children (50%) were male, 46 of 86 (53%) had manifest AP, 17 of 86 (20%) weighed less than 20\u00a0kg and in 24 of 86 children (28%) a three\u2010dimensional system (3DS) was used to reduce fluoroscopy time. The acute success rate was 98.8% (85\/86), with a recurrence rate of 2.4% (2\/85) in a mean follow\u2010up of 66.2\u00a0\u00b1\u00a042.7 (9.1\u2010184.2) months. The mean procedure time and fluoroscopy time were significantly lower for the 3DS group compared to the standard fluoroscopy group 131\u00a0\u00b1\u00a041 (55\u2010262) and 2.4\u00a0\u00b1\u00a01.5 (1\u20106) minutes vs 164\u00a0\u00b1\u00a051 (62\u2010249) and 27\u00a0\u00b1\u00a013 (8\u201077) minutes, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01 and <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001, respectively. There were no ablation\u2010related complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>RF ablation of left\u2010sided APs using TSP approach in small children had an excellent efficacy and safety profile. The use of 3DS significantly reduces the procedure and fluoroscopy time.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12219","type":"journal-article","created":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T13:46:01Z","timestamp":1564753561000},"page":"742-747","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Catheter ablation of left\u2010sided accessory pathways in small children"],"prefix":"10.1002","volume":"35","author":[{"given":"Rami","family":"Fogelman","sequence":"first","affiliation":[{"name":"The Schneider Children\u2019s Medical Center of Israel Cardiology Institute, Sackler School of Medicine, Tel Aviv University Petach Tiqva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Einat","family":"Birk","sequence":"additional","affiliation":[{"name":"The Schneider Children\u2019s Medical Center of Israel Cardiology Institute, Sackler School of Medicine, Tel Aviv University Petach 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