Outcomes of Ventricular Tachycardia Catheter Ablation in Pediatric Arrhythmogenic Right Ventricular Cardiomyopathy

doi:10.1161/circep.125.014075

Outcomes of Ventricular Tachycardia Catheter Ablation in Pediatric Arrhythmogenic Right Ventricular Cardiomyopathy

Circ Arrhythm ElectrophysiolPublished 13 Oct 2025Fifteen patients who fulfilled the 2010 arrhythmogenic right ventricular cardiomyopathy task force criteria

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Authors' conclusion

Pediatric arrhythmogenic right ventricular cardiomyopathy RFCA is safe, but early recurrences are common, requiring repeat ablations and sometimes bilateral cardiac sympathetic denervation. The substrate is mostly epicardial with preserved endocardial voltage. VT free survival is 73% after multiple procedures. Progressive heart failure requiring transplantation occurred in 13% within 2 decades of initial presentation.

Study context

Population: Patients fulfilling the 2010 ARVC task force criteria who clinically presented before age 18 and underwent ventricular tachycardia (VT) radiofrequency catheter ablation (RFCA) at ≤21 years oldpatients included
Participants: Fifteen patients

Main finding

As reported in the abstract

Age at symptom onset and index procedure; sex

Mean age at symptom onset

15.5±1.6 years

Age at index procedure

18.1±2 years

Male

73%

Further findings

Pathogenic desmosomal mutation

Detected: 87%

First presentation symptoms

Palpitations: 33%
Syncope: 27%
Sustained VT: 27%
Sudden cardiac arrest: 13%

ECG repolarization abnormalities; athletes

ECG repolarization abnormalities: 93%
Athletes: 40%

Sustained monomorphic VT induced at index procedure

Induced: 60%

Electroanatomic mapping substrate

Basal RV epicardial substrate: 100%
Endocardial low voltage/scar: 54%

Repeat VT ablation · mean follow-up of 16.4 months

Required: 80%

Number of procedures and sustained VT-free survival · mean follow-up duration of 21.4 months

Median number of procedures: 2 (interquartile range, 2-4)
Sustained VT-free survival: 73%

Bilateral cardiac sympathetic denervation for recurrent ventricular arrhythmia

Performed: 27%

Advanced heart failure with heart transplantation

Patients: 2 patients (13%)

Safety

Acute periprocedural complications

No acute periprocedural complications occurred

Original publication

Outcomes of Ventricular Tachycardia Catheter Ablation in Pediatric Arrhythmogenic Right Ventricular Cardiomyopathy. Circ Arrhythm Electrophysiol. Published 13 October 2025. doi:10.1161/circep.125.014075

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Summarised from the published abstract; every number is checked against it