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Innovative new treatment for children with heart conditions

Electrophysiology workstation in the Children’s Heart Center Vienna extends the offering for children with cardiac arrhythmia
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(Vienna, 04 December 2019) Despite treatment with medication, two children repeatedly experienced attacks of tachycardia. The two patients were treated under the supervision of Manfred Marx, Division of Pediatric Cardiology of the Children's Heart Center Vienna within Vienna General Hospital, Medical University Campus, using a catheter technique that shrinks the defective electrical pathways in the heart by delivering a targeted electrical pulse.

The procedures (EPU) were carried out in the heart catheter area of the Division of Pediatric Cardiology of the Department of Pediatrics and Adolescent Medicine, MedUni Vienna and Vienna General Hospital, which has been extended to include a modern electrophysiology workstation. The Ensite Precision Mapping System is used to produce a 3D electrical "map" of the heart and pinpoint the region where electrical transmission is faulty. The system is also adapted to the particular needs of children, so that smaller catheter dimensions and configurations are used than would be appropriate for adults.

The EPU unit is one of the most modern devices of its type. It is a refinement of the previous technology, which exposed children to a higher dose of x-rays during the examination. The procedure can now be carried out with much less radiation, or no radiation at all, using the three-dimensional mapping system. The system is supplemented by the Claris EP measuring station, which provides high-quality recording and storage of medical data without interference signals. This enables ultra precise location of the lesion causing the arrhythmia and, especially in view of the size of the children’s hearts, this increases patient safety, as well as the chances of the treatment being successful.

Up to five catheters are placed in various regions of the heart via the inguinal vessels, allowing detailed recording of the electrical currents in the heart. Within fragments of a second, the direction of the current changes with each heartbeat and this analysis ultimately pinpoints the area that is triggering arrhythmia in the patients. This area is then located by a special ablation catheter and electrical stimulation is emitted by the Ampere RF generator with a precisely measured contact pressure and this isolates the electrical focus. In most cases the continuous ECG that is simultaneously recorded shows whether the procedure has been successful and the dangerous tachycardia has been cured.

Manfred Marx' team was supported by Mattias Gass from Zürich, one of the top electrophysiologists for paediatric cardiac arrhythmia in Europe. Thanks to his expertise and the deployment of specially trained radiographers, the examinations of both patients went without a hitch and the children were allowed home after only a few days.

The Children’s Heart Center Vienna has a specialist heart rhythm clinic and looks after the largest number of children in Austria with cardiac arrhythmia, from new-borns through to adolescents. Up until now, electrophysiology examinations and treatment have been carried out in the Division of Cardiology, led by Christian Hengstenberg, and there is still close collaboration with this division. With the increasing complexity of arrhythmia disorders, e.g. in connection with congenital heart defects, it became necessary to include a further specialisation and location in paediatric cardiology and this has now been implemented with support from the Medical Director, Gabriella Kornek, and the Director of Vienna General Hospital, Herwig Wetzlinger.

"We are now able to treat sometimes life-threatening childhood cardiac arrhythmia with even greater precision, while at the same time providing greater patient safety for the younger children of Vienna," explains Ina Michel-Behnke, Head of the Division of Pediatric Cardiology of the Department of Pediatrics and Adolescent Medicine/Children’s Heart Center Vienna.