Serial Changes of CK, CK-MB after Radiofrequency Catheter Ablation in Pediatric Patients

ABSTRACT

PURPOSE: To investigate the degree of myocardial injury incurred by radiofrequency catheter ablation(RFCA), we serially measured CK, CK-MB levels in 24 pediatric paroxysmal supraventricular tachycardia patients undergoing RFCA(male 12, female 12, mean age 10.5 years, mean weight 37.2 kg). METHODS: We serially measured blood CK, CK-MB levels, 1 day before RFCA(baseline), 8 hours after RFCA(stage 1), 16 hours after RFCA(stage 2), 24 hours after RFCA. Serial changes of CK, CK-MB levels were compared with baseline levels, age, body weight, number of applied RFCAs, total duration of RFCAs and the site of ablation(left heart ablation, right heart ablation). RESULTS: Compared with baseline levels of CK, CK-MB, there were significant increases in CK and CK-MB levels in stage 1(base line 130.7+/-54.0 U/L, 1.97+/-1.74 micro gram/L, stage 1 233.7+/-165.1, P=0.04, 7.71+/-7.96, P=0.01, stage 2 207.4+/-131.3, P=0.19, 6.51+/-8.54, P=0.08, stage 3 215.7+/-151.4, P=0.13, 5.09+/-4.38, P=0.36). The CK level was found to be elevated(>195 u/L) in 13 patients(54 %), while the CK-MB level was elevated(>5 micro gram/L) in 12 patients(50%). Comparing left heart ablations(n=11) and right heart ablations(n=13), CK-MB level in stage 1 was significantly increased in left heart ablation(12.29+/-9.79 micro gram/L, 3.82+/-2.48, P=0.02). In right heart ablations, there were significant correlations between the number of applied RFCAs and CK-MB level in stage 1(P=0.02, r=0.65). CONCLUSION: Significant myocardial injury was incurred by RFCA. Considering the small growing heart of pediatric patients, we should take efforts to minimize myocardial injuries.