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.