Introduction: The aim of this study was to describe our experience and outcome of ablation therapy of arrhythmias in children at a tertiary care center. Methods: Data was collected retrospectively from the hospital medical records. All children presenting to AUBMC between 2000 and 2020 who underwent cardiac ablation were included. The data collected included type of arrhythmia, ablation technique, age and weight at ablation, procedure complications, medications used, and outcome assessment. Results: We had 67 patients who underwent cardiac ablation. Of those, 60% were males with a mean age of 15 years. Structural heart disease was present in 6% of patients. Wolff-Parkinson-White syndrome (WPW) was most prevalent at 31%, followed by atrioventricular nodal reentrant tachycardia (AVNRT) at 24%, atrioventricular reentrant tachycardia (AVRT) at 19%, ventricular tachycardia (VT) at 10%, atrial fibrillation (AF) at 2%, and atrial tachycardia (AT) at 1%. The remaining 13% of patients presented with less common types of arrhythmias, including narrow complex tachycardia, retrograde dual atrioventricular nodal reentry, premature ventricular contractions (PVC), and orthodromic reciprocating tachycardia. Antiarrhythmic medications were started prior to the procedure in 59% of our population. Medication regimens post-ablation included beta blockers (68%), type 1c antiarrhythmics (25%), calcium channel blockers (3%), ivabradine (2%), and amiodarone (2%). The completed procedures showed a success rate of 93%. Conclusion: Ablation of arrhythmias in children is an effective procedure in the treatment of childhood arrhythmias. More studies are needed on cardiac ablation in children with structural heart disease in the Middle East region.

Background: Left ventricular (LV) pacing with resynchronization therapy improves ventricular synchrony in patients with decreased LV function and Left Bundle Branch Bock (LBBB). Objective: The goal of this study is to show that LV pacing is superior to BiVentricular (BiV) pacing in patients with ventricular dysfunction and LBBB. Methods: This is a retrospective study from 2 hospitals’ registries in Lebanon. 121 patients with LVEF ≤ 35%, a QRS ≥130msec and a LBBB pattern on full medical therapy were included in 2 groups: LV pacing and BiV pacing. All patients had echocardiograms before and after device implantation. The primary endpoint was the change in ejection fraction and the secondary endpoints were decrease in pulmonary artery pressure (PAPs), in LV end diastolic diameter (LVDD) and in LV end systolic diameter (LVSD). Statistical analysis was done with SPSS. Results: The study population was mostly males (69.4%) with ischemic cardiomyopathy 74 (61.2%) & a mean age of 67 years old. Fifty (41,3%) patients were programmed as LV pacing. A statistically significant improvement in EF was seen in the LV only 9.2% compared to BiV pacing 5.5%. Similarly, we noticed a significant decrease in the LVDD and LVSD in the LV pacing compared to the second group. There was a trend in favor of more PAPs improvement in the LV pacing that did not reach significance. Conclusion: This study demonstrates that LV pacing significantly improves EF and LV size compared to BiV pacing. A large multicenter trial is needed to confirm our findings.