Journal of JCIC

In Wolff-Parkinson-White (WPW) syndrome, there is an accessory atrioventricular pathway (AP) that can allow atrioventricular conduction other than through the atrioventricular node, which can cause various arrhythmias. Radiofrequency catheter ablation is an established method of therapy for WPW syndrome. APs are considered to be structures remaining from the embryonic stage. Most atrioventricular reentrant tachycardias in both fetuses and newborns resolve spontaneously within the first months of life, and >60％ of patients require no antiarrhythmic drug therapy, and remain free of symptoms after the age of 1 year. To perform catheter ablation for WPW syndrome in children, it is necessary to consider the natural history, cardiac malformation, cardiac function, severity and frequency of arrhythmias, drug resistance, and position of an accessory conduit, etc. In Japan, catheter based cryoablation has been introduced and approved for atrioventricular nodal reentrant tachycardia. This treatment is expected as a safe catheter ablation treatment for septal APs, which may result in atrioventricular block.