Conclusions
Recurrent accessory pathway ablation in children remains a challenge even in expert’s hand. There is inherent logic to adapt the procedure in terms of energy used, catheter choice and mapping strategy depending on the location of the pathways. Technology improvements have been impressive in recent years and collaborate to improve procedure outcomes. However, the cornerstones of successful and safe pediatric accessory pathway ablation remain a deep understanding of the anatomic landmarks, meticulous mapping including pacing strategies when necessary, and catheter stability with adequate energy delivery during applications.