Outcomes From Pediatric Ablation: A Review of 20 Years of National Data

This study set out to examine outcomes from pediatric supraventricular tachycardia ablations over a 20-year period. This study sought to examine success rates and repeat ablations over time and to evaluate whether modalities such as 3-dimensional (3D) mapping, contact force, and cryotherapy have imp...

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Published in:JACC. Clinical electrophysiology 2021-11, Vol.7 (11), p.1358-1365
Main Authors: Walsh, Mark A, Gonzalez, Cecilia M, Uzun, Orhan J, McMahon, Colin J, Sadagopan, Shankar N, Yue, Arthur M, Seller, Neil, Hares, Dominic L, Bhole, Vinay, Till, Jan, Wong, Leonie, Mangat, Jasveer S, Lowe, Martin D, Rosenthal, Eric, Bowes, Michael, Stuart, Alan G
Format: Article
Language:English
Subjects:
Accessory Atrioventricular Bundle
Catheter Ablation
Child
Fluoroscopy
Humans
Tachycardia, Atrioventricular Nodal Reentry - surgery
Tachycardia, Supraventricular - epidemiology
Tachycardia, Supraventricular - surgery
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container_issue 11
container_start_page 1358
container_title JACC. Clinical electrophysiology
container_volume 7
creator Walsh, Mark A
Gonzalez, Cecilia M
Uzun, Orhan J
McMahon, Colin J
Sadagopan, Shankar N
Yue, Arthur M
Seller, Neil
Hares, Dominic L
Bhole, Vinay
Till, Jan
Wong, Leonie
Mangat, Jasveer S
Lowe, Martin D
Rosenthal, Eric
Bowes, Michael
Stuart, Alan G
description This study set out to examine outcomes from pediatric supraventricular tachycardia ablations over a 20-year period. This study sought to examine success rates and repeat ablations over time and to evaluate whether modalities such as 3-dimensional (3D) mapping, contact force, and cryotherapy have improved outcomes. Ablation of supraventricular tachycardia in pediatric patients is commonly performed in most congenital heart centers with excellent long-term results. Data were retrieved from the NICOR (National Institute of Clinical Outcomes Research) database in the United Kingdom. Outcomes over time were evaluated, and procedure-related details were compared. There were 7,069 ablations performed from January 1, 1999, to December 31, 2018, at 10 centers. Overall, ablation success rates were 92% for accessory pathways, 97% for atrioventricular node re-entry tachycardia, and 89% for atrial tachycardia. There was an improvement in procedural success rates over time (p 
doi_str_mv 10.1016/j.jacep.2021.03.012
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This study sought to examine success rates and repeat ablations over time and to evaluate whether modalities such as 3-dimensional (3D) mapping, contact force, and cryotherapy have improved outcomes. Ablation of supraventricular tachycardia in pediatric patients is commonly performed in most congenital heart centers with excellent long-term results. Data were retrieved from the NICOR (National Institute of Clinical Outcomes Research) database in the United Kingdom. Outcomes over time were evaluated, and procedure-related details were compared. There were 7,069 ablations performed from January 1, 1999, to December 31, 2018, at 10 centers. Overall, ablation success rates were 92% for accessory pathways, 97% for atrioventricular node re-entry tachycardia, and 89% for atrial tachycardia. There was an improvement in procedural success rates over time (p &lt; 0.01). The use of 3D mapping did not alter success or need for repeat ablation but was associated with a higher proportion of lower fluoroscopy cases; 55% of 3D mapping cases used &lt;5 min of fluoroscopy (p &lt; 0.01). Patients needing a repeat ablation were 341 (12%) for accessory pathways, 128 (7%) for atrioventricular node re-entry tachycardia, and 35 (7%) for atrial tachycardia. Overall, the risk of complete heart block was low (n = 12, &lt;0.01%). The use of cryotherapy was associated with an increased risk of needing a repeat ablation. Overall success rates from pediatric ablations are excellent and compare favorably to other registries. Introduction of newer technologies have likely made procedures safer and reduced radiation exposure, but they have not changed success rates or the need for a repeat procedure.</description><identifier>EISSN: 2405-5018</identifier><identifier>DOI: 10.1016/j.jacep.2021.03.012</identifier><identifier>PMID: 34217658</identifier><language>eng</language><publisher>United States</publisher><subject>Accessory Atrioventricular Bundle ; Catheter Ablation ; Child ; Fluoroscopy ; Humans ; Tachycardia, Atrioventricular Nodal Reentry - surgery ; Tachycardia, Supraventricular - epidemiology ; Tachycardia, Supraventricular - surgery</subject><ispartof>JACC. Clinical electrophysiology, 2021-11, Vol.7 (11), p.1358-1365</ispartof><rights>Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. 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subjects Accessory Atrioventricular Bundle
Catheter Ablation
Child
Fluoroscopy
Humans
Tachycardia, Atrioventricular Nodal Reentry - surgery
Tachycardia, Supraventricular - epidemiology
Tachycardia, Supraventricular - surgery
title Outcomes From Pediatric Ablation: A Review of 20 Years of National Data
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