Prospective assessment after pediatric cardiac ablation: demographics, medical profiles, and initial outcomes.
BACKGROUND
A multicenter prospective study was designed and implemented to assess the short- and longer-term results and risks associated with radiofrequency (RF) ablation in children.


RESULTS
Patients recruited for the study were aged 0 to 16 years with supraventricular tachycardia due to accessory pathways or AV nodal reentrant tachycardia (AVNRT), excluding patients with nontrivial congenital heart disease. A national registry also was established, and contributing centers were encouraged to enroll all pediatric patients, aged 0 to 21 years, undergoing ablation at their center. This report summarizes acute results of these procedures. For analysis, subjects were divided into three groups: the prospective cohort (n = 481), cohort-eligible registry participants (n = 504), and not cohort eligible registry participants (n = 1,776). Prospectively enrolled cohort patients were similar to cohort-eligible patients in terms of demographic and other patient characteristics. Overall success rates for RF ablation were high (95.7%), with higher success rates for left-sided and particularly left free-wall pathways (97.8%) than right free-wall pathways (90.8%). Complications of both electrophysiologic study and RF ablation were infrequent (4.2% and 4.0%, respectively), and there were no deaths. AV block was uncommon overall (1.2%) and was limited to ablation in AVNRT (2.1%) and septal accessory pathways (3.0%).


CONCLUSIONS
Despite the multicenter and prospective design, the study demonstrates high success rates and low complication rates, which are comparable to prior single-center retrospective studies. These results may serve as the current best benchmark for expected results in the pediatric population, aged 0 to 16 years, both in terms of acute success rates and the occurrence of complications.
Van Hare
George F
GF
Department of Pediatrics, Division of Cardiology, Stanford University, Stanford, California 94304, USA. George.Van.Hare@Stanford.edu
Javitz
Harold
H
Carmelli
Dorit
D
Saul
J Philip
JP
Tanel
Ronn E
RE
Fischbach
Peter S
PS
Kanter
Ronald J
RJ
Schaffer
Michael
M
Dunnigan
Ann
A
Colan
Steven
S
Serwer
Gerald
G
D000293:Adolescent; D017115:Catheter Ablation; D002648:Child; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D011446:Prospective Studies; D012042:Registries; D013617:Tachycardia, Supraventricular / Q000503:physiopathology / Q000601:surgery*