Work

Technical Feasibility of the RHYTHMIA Mapping System in Pediatric Patients Weighing Less Than 20Kg

Year: 2026

Type: article

Abstract: BACKGROUND: Catheter ablation in pediatric patients remains technically challenging. The RHYTHMIA high-density mapping system is increasingly used in pediatric electrophysiology; however, procedural experience in patients weighing less than 20 kg is limited. METHODS: We retrospectively analyzed 125 pediatric patients who underwent catheter ablation for supraventricular arrhythmias using the RHYTHMIA system. The patients were divided into two groups according to body weight: ≥20 kg group (n = 111) and the <20 kg group (n = 14). The mapping time, number of mapping beats, and mapping electrodes were compared for the right atrium (RA), and left atrium (LA), along with the manual re-annotation points and incidence of complications. RESULTS: A total of 184 maps were analyzed. No significant differences were found in mapping time, accepted beats, and electrograms (RA, ≥20 kg group [n = 104] vs. <20 kg group [n = 11]; mapping time, 13.8 min[10.1-18.3] vs. 17.4 min[9.4-25.3], p = 0.95; accepted beats, 744 beats[548-1095] vs. 953 beats[654-1079], p = 0.57; electrograms, 6871 electrograms[5074-10885] vs. 6650 electrograms[4474-9527], p = 0.30) (LA, ≥20 kg group [n = 62] vs. <20 kg group [n = 7]; mapping time, 11.5 min[8.1-18.3] vs. 14.5 min[8.5-15.4], p = 0.97; accepted beats, 619 beats[354-1007] vs. 512 beats[316-810], p = 0.89; electrograms, 6809 electrograms[4025-10108] vs. 4338 electrograms[3369-8693], p = 0.93). In the RA, <20 kg group required more re-annotations than ≥20 kg group, while no significant differences in complications were observed between the groups. CONCLUSIONS: Use of the RHYTHMIA mapping system in carefully selected pediatric patients weighing less than 20 kg was technically feasible and not associated with major procedural complications. These findings support its cautious use with appropriate case selection and operator vigilance.

Source: Pacing and Clinical Electrophysiology

DOI: 10.1111/pace.70151