Vascular rings cause highly variable clinical presentations. This study assesses the impact of prenatal versus postnatal diagnosis on clinical outcomes.

We conducted a single centre retrospective review of isolated vascular ring patients (without significant CHD) from 2011 to 2022 and compared clinical and operative data between patients with prenatal and postnatal diagnoses.

Of 177 patients, 45% (N = 80) had prenatal diagnosis. Between 2018 and 2022, 78% had prenatal diagnosis compared to 41% from 2013 to 2018 and 4% before 2013 (p < 0.001). 76.3% (N = 135) had a right aortic arch with left ligamentum arteriosum, 22.6% (N = 40) had a double aortic arch, and 1.1% (N = 2) had a left aortic arch with right ligamentum arteriosum. Postnatal diagnosis patients were more likely to have preoperative respiratory symptoms (55.7%), medications (34.0%), or admissions (24.7%) (versus 32.5%, 10.0%, and 11.3% of the prenatal diagnosis patients, p < 0.05) and require surgical repair (68.0% versus 38.8% of prenatal diagnosis patients, p < 0.0001). 54.8% of patients had surgical repair; prenatal diagnosis patients were younger at surgery, 7.5 (3-11) months compared to 16.0 (5-18) months in the postnatal diagnosis patients (p = .0014). Double aortic arch patients were more likely to require surgical repair (90.0%, compared to 44.5% with right aortic arch, p < 1e−4). Postnatal diagnosis patients had more residual postoperative symptoms (40.9% versus 16.1% in prenatal diagnosis patients, p = 0.01).

Prenatal diagnosis of vascular rings improves clinical surveillance, resulting in earlier surgical repair in symptomatic patients and diminished morbidity. Higher risk double aortic arch patients should have a tailored evaluation pathway.

A retrospective analysis of paediatric infective endocarditis characterised causative pathogens, antimicrobial susceptibility patterns, and treatment outcomes to guide clinical decision-making.

The data of patients who received infective endocarditis between 2016 and 2023 were retrospectively collected from the medical records database. The clinical characteristics, treatment plans, and pharmaceutical monitoring characteristics were analysed and summarised.

A total of 12 paediatric infective endocarditis cases were identified. Bacterial isolates included 27 Gram-positive and 1 Gram-negative strains. The most common pathogen was Staphylococcus aureus (n = 13), all methicillin-resistant Staphylococcus aureus (MRSA), followed by Abiotrophia defectiva (n = 6), Streptococcus mitis (n = 5), Streptococcus sanguinis (n = 2), Bacillus cereus (n = 1), and Klebsiella oxytoca (n = 1). Antimicrobial therapy primarily involved linezolid, vancomycin, and cephalosporin/enzyme inhibitor combinations. Cardiac glycosides were used in 10 cases, and all patients received phosphocreatine to support myocardial energy metabolism. Therapeutic drug monitoring for vancomycin was performed in 25% of cases, while no therapeutic drug monitoring was conducted for meropenem or linezolid.

All the causative organisms were predominantly Gram-positive cocci, with MRSA accounting for the largest proportion; different streptococci varied considerably in terms of drug resistance. The antimicrobial drugs used were predominantly linezolid and glycopeptides. The rate of blood concentration monitoring was low.

Reports of paediatric cardiac neurodevelopmental programmes are predominately limited to high-volume surgical centres. Regional characterisation of neurodevelopmental care practices across multiple centres both with and without cardiac surgery programmes has not yet been described.

Assess cardiac neurodevelopmental infrastructure and approach across New England to describe regional support for children with CHD.

A 16-item survey assessing inpatient and outpatient neurodevelopmental care practices was sent electronically via REDCap to all member institutions of the New England Congenital Cardiology Association Health Disparities Working Group. Centres were characterised by surgical capability, annual volume, and academic affiliation. Descriptive statistics and Fisher’s exact test were used for comparisons.

The survey response rate was 90% (9/10). Participating centres included non-surgical academic centres (55%), small surgical centres (22%) and medium-large surgical centres (22%). Surgical centres typically refer their patients to internal neurodevelopmental services (100%) and rely on automatic referral processes (100%). Non-surgical centres predominately refer to the institution where cardiac surgery was performed (80%) compared to engaging local teams (20%) and depend on family or physician-initiated referral (100%) to schedule neurodevelopmental services. While none of the non-surgical centres surveyed have cardiac-specific neurodevelopmental programmes, all have other developmental programmes that accommodate children with CHD.

Varying neurodevelopmental infrastructure and resources are reported across New England. Academic, non-surgical centres may have infrastructure for neurodevelopmental follow-up despite not having cardiac neurodevelopmental programmes. Collaboration between surgical and non-surgical cardiac centres in New England may be leveraged to promote neurodevelopmental care closer to home.

We explore the role of targeted echocardiography as a screening tool for bicuspid aortic valve and left ventricular hypertrophy, specifically assessing the risk of missing significant cardiac findings that would otherwise be identified by comprehensive echocardiograms.

Children < 18 years at initial echocardiogram for indications of “family history of bicuspid aortic valve” and “left ventricular hypertrophy on electrocardiogram” were queried. Cardiology clinic notes and complete echocardiogram reports were reviewed for additional background histories and incidental findings. Follow-up clinic visits, if any, and management for those with incidental findings were reviewed.

Bicuspid aortic valve group included 138 patients, 71 (51%) males and mean age at comprehensive echo was 8.4 ± 4.8 years. Bicuspid aortic valve was found in 3.6%, incidental findings were found in 15 (11%), and follow-up was recommended in 4 (2.8%). Left ventricular hypertrophy group included 70 patients, 58 (83%) males and mean age at echo 10.9 ± 4.7 years. Left ventricular hypertrophy was found in 2.8%, incidental findings were found in 9 (13%), and follow-up was recommended in 2 (2.8%).

None of the follow-up group developed symptoms or required cardiac medications, exercise restrictions, or catheter or surgical-based interventions, except for one case of mild aortic root dilation who was restricted from heavy weightlifting.

The risk of missing clinically important findings with targeted echocardiography that would have been identified with comprehensive echocardiography is extremely low for screening indications of isolated left ventricular hypertrophy on electrocardiogram or family history of bicuspid aortic valve, suggesting that targeted echocardiography could be an effective screening tool.

Limited data exist on how trainers are trained in paediatric cardiology training centres in Europe.

A cross-sectional study employing a structured and approved questionnaire was circulated to educationalists/trainers in 95 Association for European Paediatric and Congenital Cardiology training centres.

Trainers provided complete data for 46 centres in 20 countries. The median number of trainers in each centre was 6 (range 1–16). The median number of years trainers were in a training role was 20 years (range 2–32 years). Sixty-six per cent of trainers received some training in being a trainer, most commonly a course by a local governing college (almost 50%). Almost 78% found such courses helpful as trainers. Sixty-eight per cent of trainers felt their education in training was optimal to be an effective trainer. Assessment of trainees varies from daily to monthly between centres. Workplace assessments (used by >90% trainers) with combined formative and summative feedback were the most common type of assessment. Only one-third of trainers understood or used entrustable professional activities. Time constraints in providing training were reported by 54% of trainers as the greatest challenge in providing training. The majority of trainers expressed a need for formal “training the trainers” courses and development of standards in training.

There is a marked variation in the level of training of trainers across Europe. A wide mix of assessment tools is used. Feedback is provided by the majority of trainers. Adopting a basic training programme for trainers may promote the training skills of paediatric cardiology trainers.

Sepsis, a life-threatening organ dysfunction resulting from a dysregulated host response to infections, poses a critical threat. Cardiac surgery itself induces a robust inflammatory response, further exacerbated by cardiopulmonary bypass, causing notable clinical and physiological changes. Identifying sepsis early in the post-operative period with elevated septic markers becomes challenging, with delayed antibiotic intervention ultimately posing a fatal risk for the patient.

We performed a prospective observational cross-sectional study aimed at identifying sepsis markers that include total leucocyte count, absolute neutrophil count, platelet count, serum albumin, chest X-ray, blood, urine, and tracheal cultures, procalcitonin, c-reactive protein, serum lactate >2.5 mmol/l along with clinical parameters (fever, hypotension, tachycardia) on post-operative days 1, 3, 5, and 10 in paediatric patients undergoing cardiac surgery with prolonged cardiopulmonary bypass time >100 min.

Total leucocyte count, absolute neutrophil count, and platelet counts were not significant enough to detect early sepsis, especially in patients with prolonged cardiopulmonary bypass time. Chest X-ray was significant from post-operative day 3 onwards. Procalcitonin was significant from day 5, and C-reactive protein was significant only from day 10. Among the clinical parameters, fever, hypotension, tachycardia, and elevated lactate levels were significant from post-operative day 1 in the patients developing sepsis.

Neonates and infants faced a higher sepsis risk than older children. Longer cardiopulmonary bypass and aortic clamp times correlated with increased sepsis likelihood. Clinical factors outweighed laboratory indicators for early sepsis detection post-cardiac surgery, prompting prompt investigation and intervention.

Congenitally corrected transposition of the great arteries is a rare congenital cardiac condition with varied presentations, complicating treatment decisions. This study evaluates the impact of medical management, physiologic repair, and anatomic repair on health-related quality of life.

A cross-sectional follow-up was conducted on 50 congenitally corrected transposition of the great arteries patients from a cohort of 240 at Cleveland Clinic (1995-2020). Health-related quality of life was assessed using MacNew and PROMIS-10 questionnaires. Echocardiographic data on systemic atrioventricular valvular regurgitation and systemic ventricular dysfunction were analysed. A time-varying coefficient model evaluated these factors’ impact on health-related quality of life.

Anatomic repair had significantly higher PROMIS-10 Physical T-scores compared to physiologic repair (median 50.9 vs 41.6, p = 0.04). MacNew Social scores were significantly higher for medical management compared to physiologic repair (median 6.8 vs 6.0, p = 0.02). Echocardiographic analysis revealed that systemic ventricular dysfunction had a stronger immediate impact on health-related quality of life. Systemic atrioventricular valve regurgitation showed a delayed negative effect, significant at 6-10 years after echo, although this effect gradually decreased over time. Anatomic repair patients had better systemic ventricular function (84.6% normal), and less systemic atrioventricular valve regurgitation (69.2% had none) compared to medical management and physiologic repair groups.

Anatomic repair improves health-related quality of life in congenitally corrected transposition of the great arteries patients, with physiologic repair showing some gains over time. Health-related quality of life data should provide important guidance regarding treatment decisions, especially in well-balanced congenitally corrected transposition of the great arteries patients.

Neonatal aortic thrombosis, though rare, is a critical condition with high morbidity and mortality. Spontaneous thrombosis is uncommon, complicating diagnosis due to its similarity to aortic coarctation. Standard treatments include heparinisation and thrombolysis, but severe cases may require interventional or surgical thrombectomy.

This case series examines interventional therapy in neonates with spontaneous aortic thrombosis, focusing on reduced systolic function or organ failure, and evaluates off-label thrombectomy devices.

Three neonates with spontaneous abdominal aortic thrombosis treated at Hannover Medical School between 2017 and 2023 were reviewed. Clinical presentation, diagnostics, treatments, and outcomes were analysed. Treatment involved therapeutic anticoagulation, systemic thrombolysis and interventional thrombectomy using off-label devices. A literature review on interventional thrombectomy in neonates was conducted.

The first neonate, with severe multi-organ failure, died after thrombectomy. The second recovered fully with systemic thrombolysis. The third, critically ill, recovered following successful thrombectomy and thrombolysis. Off-label use of the Amplatzer Vascular Plug II proved more effective than the Amplatzer Piccolo PDA Occluder for managing organised thrombus. A literature review identified seven cases of neonatal aortic thrombectomy using various devices, highlighting interventional thrombectomy as a promising treatment for neonates with cardiac decompensation or imminent organ failure.

We propose a diagnostic approach for newborns with diminished or absent femoral pulses without structural heart or vascular disease. Interventional thrombectomy is a viable option for neonates with spontaneous aortic thrombosis in life-threatening situations involving decreased systolic function or organ failure. Further studies are needed to evaluate safety and long-term outcomes of catheter-based interventions.

Cases of Fontan failure with normal Fontan pressure have been reported. This study aimed to identify catheterisation-derived haemodynamic predictors of heart transplantation/death, other than Fontan pressure, in late post-Fontan patients.

This retrospective study evaluated post-Fontan patients who underwent cardiac catheterisation at age ≥10 years between 1993 and 2018. The predictive effect of cardiac index-systemic vascular resistance index plot and perfusion pressure on freedom from the primary outcome (heart transplantation/death) was evaluated. Patients were categorised into haemodynamic categories A (cardiac index ≥ 3, systemic vascular resistance index ≥ 13), B (cardiac index < 3, systemic vascular resistance index ≥ 13), C (cardiac index ≥ 3, systemic vascular resistance index < 13), and D (cardiac index < 3, systemic vascular resistance index < 13).

In total, 79 patients (median age: 15.7 [range: 10.1–50.2] years) were included; of them, the primary endpoint occurred in 10 (13%; median follow-up: 1.9 [range: 0.1–18.8] years). Category C patients had significantly shorter freedom from the endpoint than categories A and B patients. Univariate analysis identified significant haemodynamic predictors, including Fontan pressure, pulmonary/systemic vascular resistance index, pulmonary/systemic flow, systemic arterial oxygen saturation, systemic venous oxygen saturation, systemic vascular resistance index, perfusion pressure, perfusion pressure < 53 mmHg, and category C. In multivariable analysis, perfusion pressure < 53 mmHg and category C emerged as predictors of heart transplantation/death alongside Fontan pressure.

Haemodynamic profiling of late post-Fontan patients using the cardiac index-systemic vascular resistance index plot can aid to comprehend the post-Fontan status and predict clinical prognosis.

Physiologic data streaming and aggregation platforms such as Sickbay® and Etiometry are becoming increasingly used in the paediatric acute care setting. As these platforms gain popularity in clinical settings, there has been a parallel growth in scholarly interest. The primary aim of this study is to characterise research productivity utilising high-fidelity physiologic streaming data with Sickbay® or Etiometry in the acute care paediatric setting.

A systematic review of the literature was conducted to identify paediatric publications using data from Sickbay® or Etiometry. The resulting publications were reviewed to characterise them and identify trends in these publications.

A total of 41 papers have been published over 9 years using either platform. This involved 179 authors across 21 institutions. Most studies utilised Sickbay®, involved cardiac patients, were single-centre, and did not utilise machine learning or artificial intelligence methods. The number of publications has been significantly increasing over the past 9 years, and the average number of citations for each publication was 7.9.

A total of 41 papers have been published over 9 years using Sickbay® or Etiometry data in the paediatric setting. Although the majority of these are single-centre and pertain to cardiac patients, growth in publication volume suggests growing utilisation of high-fidelity physiologic data beyond clinical applications. Multicentre efforts may help increase the number of centres that can do such work and help drive improvements in clinical care.

Northwest axis on an electrocardiogram is conventionally thought to be associated with CHD, but there is a paucity of data regarding the types and incidence of CHD associated with this finding. The purpose of this study was to report the types and incidence of CHD found at our institution to determine the efficacy of electrocardiograms as a screening test in infants.

Retrospective, single-centre study of all infants ≤ 60 days of age who underwent a first-time electrocardiogram from 2015 to 2021. Our inclusion criteria included those found to have a northwest axis on electrocardiogram and who also had an echocardiogram performed. Data were described using standard summary statistics.

Two hundred sixty-eight infants met inclusion criteria (median age 4 days, interquartile range 2–24). The most common reason for an electrocardiogram to be obtained was the presence of a heart murmur (n = 102, 38%). One hundred thirty-one infants (49%) were found to have significant CHD. Cardiac defects included ventricular septal defect (n = 36, 28%), severe pulmonary valve stenosis (n = 17, 13%), atrioventricular canal defect (n = 16, 12%), and single ventricle disease (n = 16, 12%).

In this study, nearly half (49%) of these infants with northwest axis on electrocardiogram were found to have significant CHD. Electrocardiograms remain an important screening tool for infants with findings associated with potential cardiac disease and echocardiogram is warranted for infants found to have northwest axis on a first-time electrocardiogram.

Dysphagia is common in infants born with critical CHD. Thickened liquids are often used to treat dysphagia, but associated risks limit widespread use among feeding specialists. This survey aims to assess dysphagia treatment patterns and thickened liquid use across paediatric cardiac surgical centres.

A 24-question, cross-sectional survey. Convenience and snowball sampling methods were used to engage 52 paediatric cardiac surgical centres affiliated with the Cardiac Newborn Neuroprotective Network. Descriptive statistics were used to analyse and compare responses.

Twenty-six individual respondents represented 21 unique paediatric cardiac surgical centres. Most responses were from experienced, speech–language pathologists (78%) at medium size centres (88%). Ninety-three percent of responding centres used thickened liquids to treat dysphagia and 81% only after formal instrumental assessment of swallowing. Thickened oral feeding was used for single-ventricle patients by 85% versus 69% for two-ventricle patients. Barriers to recommending thickened oral feedings included the cost of thickening agents, parental non-adherence, and gastrointestinal concerns.

This is the first survey to report multi-institutional dysphagia treatment practice variation at United States congenital cardiac surgical centres. Thickened oral feedings are frequently used across centres in high-risk critical CHD patients but treatment benefit remains unclear. This survey highlights a broad scientific community poised to direct dysphagia research in critical CHD to address practice variation, short- and long-term impact of thickened oral feeding on feeding outcomes, and barriers to use and access of thickening agents.

There is limited knowledge on titration, optimal dosing, and efficacy of angiotensin-converting enzyme inhibitors in paediatric patients following cardiac surgery.

Patients after cardiac surgery to repair ventricular septal defect or coarctation of the aorta from 01/2017 to 12/2019 were eligible for a retrospective single-centre study. Medical records were reviewed for patient characteristics and outcomes. Mean arterial pressure response and angiotensin-converting enzyme inhibitor dosage were collected. Controls were patients not receiving angiotensin-converting enzyme inhibitor postoperatively. Appropriate statistics were used for analysis.

Among a total of 286 patients [n = 188 (66%) ventricular septal defect; n = 98 (34%) coarctation of the aorta], 170 (59%) received angiotensin-converting enzyme inhibitor on any postoperative day 1 to 5. The median age was 4.9 months (IQR 1.2–14.4) and weight 5.5 kg (IQR 3.7–9.2). The most common angiotensin-converting enzyme inhibitor was captopril on day 1 [n = 117 (69%)] and lisinopril at discharge [n = 86 (51%)]. Patients in treatment group were shown to have higher median mean arterial pressure at baseline and at time 1, compared with controls (mean difference 3.57 (95% CI: 1.85, 5.35) and 3.46 (95% CI: 1.41, 5.50), respectively. Median mean arterial pressure among controls significantly increased over time with a slope of 0.97 (95% CI: 0.2, 1.74), while median mean arterial pressure among treatment group decreased with a slope of −0.31 (−0.93,0.31). Patients who received high and medium doses of angiotensin-converting enzyme inhibitor showed significantly decreasing median mean arterial pressure over time with a slope of −2.85 (−5.14, −0.56) and −1.25 (−2.4, −0.11), respectively.

High and medium dose angiotensin-converting enzyme inhibitor therapy had a greater effect in decreasing mean arterial pressure when compared to low dose.

Paediatric patients with heart failure requiring ventricular assist devices are at heightened risk of neurologic injury and psychosocial adjustment challenges, resulting in a need for neurodevelopmental and psychosocial support following device placement. Through a descriptive survey developed in collaboration by the Advanced Cardiac Therapies Improving Outcomes Network and the Cardiac Neurodevelopmental Outcome Collaborative, the present study aimed to characterise current neurodevelopmental and psychosocial care practices for paediatric patients with ventricular assist devices.

Members of both learning networks developed a 25-item electronic survey assessing neurodevelopmental and psychosocial care practices specific to paediatric ventricular assist device patients. The survey was sent to Advanced Cardiac Therapies Improving Outcomes Network site primary investigators and co-primary investigators via email.

Of the 63 eligible sites contacted, responses were received from 24 unique North and South American cardiology centres. Access to neurodevelopmental providers, referral practices, and family neurodevelopmental education varied across sites. Inpatient neurodevelopmental care consults were available at many centres, as were inpatient family support services. Over half of heart centres had outpatient neurodevelopmental testing and individual psychotherapy services available to patients with ventricular assist devices, though few centres had outpatient group psychotherapy (12.5%) or parent support groups (16.7%) available. Barriers to inpatient and outpatient neurodevelopmental care included limited access to neurodevelopmental providers and parent/provider focus on the child’s medical status.

Paediatric patients with ventricular assist devices often have access to neurodevelopmental providers in the inpatient setting, though supports vary by centre. Strengthening family neurodevelopmental education, referral processes, and family-centred psychosocial services may improve current neurodevelopmental/psychosocial care for paediatric ventricular assist device patients.

Beta blocker non-adherence is a key factor in precipitating cardiac events in patients affected by congenital long QT syndrome. Adherence has been examined in adults affected by congenital long QT syndrome but not in a large paediatric group.

Patients with congenital long QT syndrome types 1 and 2 were identified using a database curated by the Inherited Cardiac Conditions team in Northern Ireland. Medication adherence was reviewed by contacting the patient’s GP. A medication possession ratio was then calculated for the year. Adequate adherence was defined as a ratio of ≥0.8, and ideal adherence was defined as a ratio of ≥1.0. Risk factor analysis for poor adherence was performed using multivariable binary logistic regression.

99 patients’ data was suitable for analysis, 71 had LQT1 (78%) and 28 had LQT2 (28%). The median age of the children involved was ten years old. Over 36,135 days the median medication possession ratio of this patient group was 0.92. 56 patients (57%) had at least adequate adherence, of these 44 patients (44%) had ideal adherence. In contrast 43 patients (43%) had less than adequate adherence and of these six patients (6%) were completely non-adherent. Increased deprivation was significantly associated with “less than” ideal adherence Odds Ratio (OR) 1.2 95% confidence intervals CI (1.1–1.4).

Adherence in the paediatric cohort was mostly in the “adequate range.” Increased deprivation is a risk factor for “less than” ideal adherence. A small minority of patients can be identified as completely non-adherent by checking prescription records. Future studies should focus on elucidating barriers and enablers to ideal adherence in this population.

To assess short- and medium-term outcomes of VenusP-valve implantation in the pulmonary position in the paediatric population.

Percutaneous pulmonary valve implantation is now an established alternative to surgical pulmonary valve replacement, especially in those with conduits in the right ventricular outflow tract. The VenusP-valve™ (Venus Medtech, Shanghai, China) has demonstrated early efficacy in the adult population with larger conduit-free right ventricular outflow tracts. However, its use in children has not been well described.

Retrospective review of patients under 18 years of age undergoing VenusP-valve implantation at a single institution between June 2015 and February 2023.

Fifteen patients under the age of 18 years underwent VenusP-valve™ implantation. All had severe pulmonary regurgitation and fulfilled accepted criteria for pulmonary valve implantation. Mean age at valve implantation was 14.1 (range 9.8–17.9) years, and mean weight was 54.9 (34.0–98.5) kg. The valve was deployed successfully in all the patients. The valve diameter and length ranged between 28–36 mm and 25–35 mm, respectively. Mean follow-up was 3.4 (0.5–8.1) years. At follow-up, twelve patients have undergone magnetic resonance imaging MRI as part of the regular surveillance. Indexed right ventricular end-diastolic volume improved from 157.8 (140.0–197.0) ml/m2 to 117.6 (91.0–152.0) ml/m2 (p = 0.004). Pulmonary regurgitation fraction had reduced from a mean of 44.3 (31.0–60.0) % to 3.6 (0.0–15.0) % (p = 0.003).

This study demonstrates the safety and feasibility of the VenusP-valve implantation in children. Medium-term follow-up suggests that valve implantation is associated with a reduction in the degree of pulmonary regurgitation and right ventricular end-diastolic volume.

We compared the results of conventional electroanatomic mapping and high-density mapping in ablations of the right ventricular outflow tract.

Between 2014 and 2024, a total of 92 patients underwent ablation using an electroanatomic mapping system. A contact force radiofrequency ablation catheter was used in all patients, except for two who underwent cryoablation.

Our study comprised two groups, with a total of 92 patients. Among them, 45 patients underwent conventional three-dimensional mapping, while 47 patients underwent high-density three-dimensional mapping. In both groups, there were three patients with nonsustained ventricular tachycardia and two patients with sustained ventricular tachycardia, and there was no statistically significant difference in the frequency of ventricular premature contractions between the two groups. There were four patients with systolic dysfunction in the high-density mapping group and four in the conventional mapping group. In the high-density mapping group, the procedure time was significantly shorter. There was a notable difference regarding the reduced fluoroscopy time. The total lesion time and number were also significantly lower in the high-density mapping group. The earliest activation time was significantly longer in this group. The procedure’s success rate was 97.9% for the high-density mapping group and 93.4% for the conventional mapping group. Successful ablation was performed on one ventricular extrasystole in the parahisian localisation in each group, while a cooled type radiofrequency catheter was used for all other cases.

In children with right ventricular outflow tract arrhythmias, high-density mapping can be used with high success rates and safety.