Background: Diagnosis and treatment of paediatric arrhythmias remain challenging. Antiarrhythmic - drugs beta-blockers, class Ic and class III drugs, were the only treatment available for many years. Radiofrequency catheter ablation (RFCA) was introduced for adult patients in 1981 and has been used for children since 1989. Questions remain regarding the efficacy and safety in paediatrics.Method: A retrospective analysis of patient records, 12 years and younger, at Leuven University Hospital, from January 2011 - July 2015 was performed.Results: From January 2011 - July 2015, 51 ablations were performed in 44 patients ≤12 years of age. Mean age was 7 years (range 3 weeks - 12 years), 11 (21.5%) ≤2 years; mean weight 16.5kg (range 3.4 - 56kg); average screening time 33.5min (SD } 22.7). Echocardiography was normal in 32 (72.7%) of patients. All cases were done under general anaesthesia. Diagnosis at electrophysiological study: Atrioventricular reentry tachycardia in 26 (50.9%), atrial ectopic tachycardia in 7 (13.7%), intra-atrial reentry tachycardia in 5 (9.8%), atrioventricular nodal reentry tachycardia in 11 (21.6%) and ventricular tachycardia in 2 (3.9%). RFCA was successful in 44 (86.3%) with recurrence rate of 13.7%. No signifi cant complications were noted.Conclusion: RFCA can be performed safely and effectively in even the very young. Recurrence and complication rates are similar to those reported in adults. RFCA should be the treatment of choice in selected paediatric patients.

Reentry

Atrial tachycardia

Radiofrequency catheter ablation

10.24170/14-1-1864

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Bacteraemia after leadless pacemaker implantation

Authorea (2020)

Christophe Garweg Bert Vandenberk Sander Jentjens S Foulon Patrick Hermans

Background: Transvenous permanent pacemaker related infection is a severe condition associated with significant morbidity and mortality. Leadless pacemakers may be more resistant to bacterial seeding during bloodstream infection because of its small surface area and encapsulation in the right ventricle. This study reports the incidence and outcomes of bacteraemia in patients implanted with a Micra leadless pacemaker. We present 18F-FDG PET/CT findings obtained in a sub-group of patients. Methods: We report a retrospective cohort study of 155 patients who underwent a Micra TPS implant procedure at the University Hospitals of Leuven between July 2015 and July 2019. We identified the patients who developed an episode of bacteraemia, proved by ≥2 positive blood cultures. Results: Of the 155 patients, 15 patients presented an episode of bacteraemia at a median of 226 days (range: 3-1129) days after the implant procedure. Gram positive species accounted for 73.3% (n=11) of the bacteraemia including Staphylococcus (n=5), Enterococcus (n=3) and Streptococcus (n=3). The source of infection was identified in 9 patients (60%) including endocarditis in 4 patients, urinary tract in 3 patients, and skin in 2 patients. 18F-FDG PET/CT imaging performed in 6 patients did not show sign of infection around the leadless pacemaker. Bacteraemia was resolved in all patients after adequate antibiotherapy. Four patients died early during follow up. For all other patients, there were no recurrence of bacteraemia during a median follow up of 263 days (range 15-1134). Conclusion: In our small cohort, no leadless pacemaker endocarditis was observed among patients with bacteraemia.

Bacteremia

10.22541/au.158809460.07887558

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3D beeldgestuurde behandeling van hartritmestoornissen

Stijn De Buck Joris Ector

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P270Individualized QT correction (QTi) derived from holter recordings is a powerful tool in the diagnosis of LQTS

EP Europace (2017)

Tomas Robyns Dieter Nuyens Bert Vandenberk Christophe Garweg Joris Ector

10.1093/ehjci/eux171.025

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ABSTRACTS

EP Europace (2009)

Amir AbdelWahab Martin J. Gardner R. Parkash Magdy N. Basta Jeff Sapp

10.1093/europace/eup171

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Asymmetric collimation can significantly reduce patient radiation dose during pulmonary vein isolation†

EP Europace (2011)

Stijn De Buck André La Gerche Joris Ector Jean‐Yves Wielandts Pieter Koopman

AimsCurrent fluoroscopic and 3D image-guided treatment of atrial fibrillation (AF) by radiofrequency ablation is characterized by a substantial amount of X-ray radiation. We investigated the potential of an asymmetric collimation technique to reduce dose.

Collimated light

Isolation

Cardiac Ablation

10.1093/europace/eur346

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Citations (14)

An unexpected response to adenosine in broad QRS tachycardia

Acta Cardiologica (2022)

Laurens Verhaeghe Thomas Rosseel Tim Van Puyvelde Peter Haemers Joris Ector

"An unexpected response to adenosine in broad QRS tachycardia." Acta Cardiologica, ahead-of-print(ahead-of-print), pp. 1–2

10.1080/00015385.2022.2042929

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