title: How are arrhythmias managed in the paediatric population in Europe? Results of the European Heart Rhythm survey.
abstract: The aim of this survey was to provide insight into current practice regarding the management of paediatric arrhythmias in Europe. The survey was based on a questionnaire sent via the Internet to the European Heart Rhythm Association (EHRA) electrophysiology research network centres. The following topics were explored: patient and treatment selection, techniques and equipment, treatment outcomes and complications. The vast majority of paediatric arrhythmias concerns children older than 1 year and patients with grown-up congenital heart disease. In 65% of the hospitals there is a specialized paediatric centre, and the most commonly observed arrhythmias include Wolff-Parkinson-White syndrome and atrioventricular nodal re-entry tachycardias (90.24%). The medical staff performing paediatric catheter ablations in Europe are mainly adult electrophysiology teams (82.05% of the centres). Radiofrequency is the preferred energy source used for paediatric arrhythmia ablation. Catheter ablation is only chosen if two or more antiarrhythmic drugs have failed (94.59% of the centres). The majority of the centres use flecainide (37.8%) or atenolol (32.4%) as their first choice drug for prevention of recurrent supraventricular arrhythmias. While none of the centres performed catheter ablation in asymptomatic infants with pre-excitation, 29.7% recommend ablation in asymptomatic children and adolescents. The preferred choice for pacemaker leads in infants less than 1 year old is implantation of epicardial leads in 97.3% of the centres, which continues to be the routine even in patients between 1 and 5 years of age as reported by 75.68% of the hospitals. Almost all centres (94.59%) report equally small number of complications of catheter ablation in children (aged 1-14 years) as observed in adults.
authors.affiliation: Cardiology Department, Ramon y Cajal Hospital, Alcalá University, CarreteraColmenar Viejo 28034 Madrid, Spain antoniomadri@gmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Hernández-Madrid
authors.affiliation: HôpitalCardiologique du Haut LévêqueUniversité Victor Segalen Bordeaux II, Bordeaux 33604 Pessac, France.
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.affiliation: Institute of Medicine and Department of Heart Disease, Haukeland University Hospital, University of Bergen, N-5021 Bergen, Norway.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.affiliation: School of Medicine, Belgrade University, Cardiology Clinical centre Serbia, 11000 Belgrade, Serbia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Potpara
authors.affiliation: Dept. of Cardiology, Maastricht University, Medical Centre, 6229 HX Maastricht, The Netherlands.
authors.forename: Laurent
authors.initials: L
authors.lastname: Pison
authors.affiliation: Department of Cardiology, Institution of Medical Science, Uppsala University, 75185 Uppsala, Sweden.
authors.forename: Carina
authors.initials: C
authors.lastname: Blomström-Lundqvist
mesh_terms: D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000453:epidemiology* / Q000628:therapy*; D001262:Atenolol / Q000627:therapeutic use*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005060:Europe / Q000453:epidemiology; D005260:Female; D005424:Flecainide / Q000627:therapeutic use*; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
chemical_list: D000889:Anti-Arrhythmia Agents; D001262:Atenolol; D005424:Flecainide
keywords: Ablation; Arrhythmia; Children; Congenital heart disease; EHRA survey; EP wire; Pacing; Paediatric; Supraventricular tachycardia