Radiofrequency catheter ablation of supraventricular tachycardia in children and adolescents : feasibility and cost-effectiveness in a low-income country

• Published in: Pediatric cardiology 2006-08, Vol.27 (4), p.434-439
• Main Authors: Vida, Vladimiro L, Calvimontes, Gonzalo S, Macs, Maximo O, Aparicio, Patricia, Barnoya, Joaquin, Castañeda, Aldo R
• Format: Article
• Language: English
• Subjects: Adolescent; Anti-Arrhythmia Agents - economics; Anti-Arrhythmia Agents - therapeutic use; Catheter Ablation - adverse effects; Catheter Ablation - economics; Child; Cost-Benefit Analysis; Electrophysiologic Techniques, Cardiac; Feasibility Studies; Female; Follow-Up Studies; Guatemala; Humans; Male; Reoperation; Retrospective Studies; Tachycardia, Supraventricular - drug therapy; Tachycardia, Supraventricular - economics; Tachycardia, Supraventricular - surgery; Treatment Outcome
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-006-1220-8

The objective of this study is to provide results and costs of catheter ablation in children and adolescents in a low-income country. Reports from first-world countries have demonstrated the cost-effectiveness of radiofrequency catheter ablation (RFCA) compared to medical treatment of supraventricular tachycardia (SVT). The study included 28 patients younger than 18 years of age with SVT in a pediatric cardiology unit in Guatemala. All patients underwent RFCA. Clinical outcome and cost-effectiveness of RFCA compared to continued medical treatment were the end points. Twenty-four patients had successful ablation (85.7%). Mean age at RFCA was 11.42 +/- 3.49 years. Three patients underwent a second ablation, increasing the success rate to 96.4%. One remaining patient is awaiting a second procedure. At a mean follow-up of 13.69 +/- 7.16 months, all 27 patients who had a successful ablation remained in sinus rhythm. Mean cost per procedure was 4.9 times higher than that of medical treatment. However, the estimated cost of catheter ablation equal that of medical therapy after 5.1 years and is 3.4 times less after 20 years. Radiofrequency catheter ablation of SVT in children and adolescents is safe and cost-effective compared to medical therapy. Resources must be judiciously allocated, especially in low-income countries, to treat the largest number of pediatric patients.