title: Impact of curative ablation on pharmacologic management in children with reentrant supraventricular tachycardias.
abstract: BACKGROUND
  The introduction of radiofrequency catheter ablation as a curative treatment option has led to a much better outlook for children with recurrent supraventricular reentrant tachycardias (SVT). This study sought to evaluate the impact of ablation on pharmacologic treatment of SVT.
  
  
  METHODS
  Two time periods were retrospectively compared with regard to number of episodes of SVT in different age groups, number of acute drug conversions of SVT, chronic antiarrhythmic drug treatments prescribed: in the first period (1989-1994) management of SVT was exclusively pharmacological whereas during the second period (1995-2000) ablation was an option for patients aged 5 years or older.
  
  
  RESULTS
  The study included 88 pediatric patients with recurrent SVT, 40 in the first period, 48 in the latter. Of these, 16 children (all >5 years of age) had an ablation procedure during the second time period. In patients aged >5 years, the number of documented SVT fell from a mean of 3.7/patient to two episodes. The number of acute drug conversions of SVT decreased from a mean of 1.1/patient to 0.2 (p<0.05) during the second period. In the group of children aged >5 years chronic antiarrhythmic treatment was given during a mean of 15 months/patient in period one compared to 4.6 months (p<0.05) in the second period.
  
  
  CONCLUSIONS
  In the current era with increasing use of ablation as first-line treatment in older children with recurrent SVT, acute as well as chronic pharmacologic intervention for SVT has become significantly less frequent.
authors.affiliation: Division of Pediatric Cardiology, University Children's Hospital Berne, CH 3010 Bern, Switzerland. jean.pierre.pfammatter@insel.ch
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pfammatter
authors.forename: Mladen
authors.initials: M
authors.lastname: Pavlovic
authors.forename: Urs
authors.initials: U
authors.lastname: Bauersfeld
mesh_terms: D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D012008:Recurrence; D012189:Retrospective Studies; D013617:Tachycardia, Supraventricular / Q000188:drug therapy* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents