alexa Electroanatomical mapping systems and cardiac arrhythmias: avoiding radiations in pediatric patients
ISSN: 2167-0897

Journal of Neonatal Biology
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Review Article

Electroanatomical mapping systems and cardiac arrhythmias: avoiding radiations in pediatric patients

Casale Matteo1*, Mezzetti Maurizio2, Tulino Viviana3, Morelli Marco2, Ciccarelli Iacopo2, Maffei Simone2, Giovagnoli Andrea2, Busacca Paolo2 and Dattilo Giuseppe1

1Department of Clinical and Experimental Medicine, University of Messina, Italy

2Operative Unit of UTIC and Cardiology, Hospital S. Maria della Misericordia, Asur AV 1 Marche, Urbino, Italy

3Neonatal Intensive Care Unit, Hospital “Barone Romeo”, Patti, ASP 2 Messina, Italy

Corresponding Author:
Casale Matteo
Department of Clinical and Experimental Medicine
Section of Cardiology, University of Messina
Via Consolare Valeria n.1, Azienda Ospedaliera Universitaria “G. Martino”
98125 Messina, Italy
E-mail: [email protected]

Received date: January 04, 2017; Accepted date: January 19, 2017; Published date: January 25, 2017

Citation: Matteo C, Maurizio M, Viviana T, Marco M, Iacopo C, et al. (2017) Electroanatomical Mapping Systems and Cardiac Arrhythmias: Avoiding Radiations in Pediatric Patients. J Neonatal Biol 6:245. doi:10.4172/2167-0897.1000245

Copyright: © 2017 Matteo C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction. Cardiac arrhythmias are challenging conditions in pediatric patients, especially in the case of newborns. Most of the tachyarrhythmias in children (90,24%) are atrioventricular reentrant tachycardias (AVRT) and atrioventricular nodal reentrant tachycardias (AVNRT). Although the standard 12-lead ECG maintains high diagnostic value, an invasive electrophysiological study and a catheter ablation are often required. Unfortunately these procedures are burdened by the use of radiations. Materials and Methods. We performed a systematic research in PubMed and Embase. We found 257 articles of interest but we selected only 36 as the most representative. Discussion: The main concerns linked to electrophysiological procedures are the need of fluoroscopy and thus the risk of malignancy as well as dermatitis, cataracts, thyroid diseases and birth defects. Children and especially newborns have a greater life expectancy so their cumulative risk is greater than adults. For this reason the guiding principle in electrophysiological procedures involving radiations in pediatric subjects is as low as reasonably achievable (acronym: ALARA). The development of 3-dimensional (3-D) electroanatomical mapping systems allowed a significant reduction of radiation exposure during ablations. The most recent experiences demonstrated the feasibility and the safety of fluoroless ablation procedures of the most common arrhythmias in children. Conclusions: Cardiac arrhythmias could be very challenging conditions in pediatric patients. Predictors of complications are a body weight <15 kg and an age <4 years so it is clear that newborns are the most difficult patients. It is reasonable, because of these evidences, to approach cardiac arrhythmias pharmacologically in younger subjects. More than 20 years of experiences conducted by the electrophysiologists allow us to encourage the use of the electroanatomical mapping systems, with the objective of reducing the radiation exposure in children, especially when accessory pathways are involved.

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