• • Treatment of supraventricular tachycardia (SVT).

  • • Life-threatening arrhythmia unresponsive to medications.

    • Younger children with arrhythmia refractory to antiarrhythmic medications.

    • Older children with recurrent SVT.

    • Older children with SVT associated with preexcitation.

  • Treatment of ventricular tachycardia.

  • • Younger children with life-threatening ventricular tachycardia refractory to medications.

    • Older children with recurrent ventricular tachycardia refractory to medications.

    • Older children with recurrent ventricular tachycardia who are unable to tolerate medications due to side effects, or who choose to have procedure.

Absolute

• • Lack of vascular access.

Relative

• • Infants with arrhythmia controlled by medications.

  • Patients with multiorgan system disease.

  • Patients with hemodynamic instability unable to tolerate procedure or anesthesia.

• • Cardiac catheterization laboratory.

  • Biplane fluoroscopy.

  • Monitoring for continuous heart rate, blood pressure, oxygen saturation.

  • Respiratory monitoring and support.

  • Vascular access.

  • Anesthesia.

  • Resuscitation equipment, including medications and cardiac defibrillator.

  • Electrode catheters, ablation catheters, energy delivery generator.

• • Hemodynamically unstable arrhythmias.

  • Bleeding.

  • Infection.

  • Vascular injury, including coronary artery damage.

  • Pneumothorax.

  • Cardiac perforation.

  • Thromboembolism.

  • Stroke.

  • Radiation exposure.

  • Cardiac valve injury.

  • Conduction system injury, including complete heart block; may necessitate implantation of permanent pacemaker.

  • Risk of injuring the normal conduction system is highest for right septal ablation sites.

  • Cardiac arrest.