Long-term results of paediatric radiofrequency catheter ablation: a population-based study

Authors

KUBUŠ Peter VÍT Pavel GEBAUER Roman A. ZAORAL Libor PEICHL Petr FIALA Martin JANOUŠEK Jan

Year of publication 2014
Type Article in Periodical
Magazine / Source Europace
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1093/europace/euu087
Field Cardiovascular diseases incl. cardiosurgery
Keywords Radiofrequency ablation; Children; Tachycardia; Congenital heart disease; Paediatric
Description Aims: We aimed to evaluate long-term utilization and results of paediatric radiofrequency catheter ablation (RFCA) in a population-based study. Methods: and results Data from all three centres performing paediatric RFCA for the whole population of the Czech Republic between 1993 and 2010 were retrospectively reviewed. A total of 708 ablation procedures in 633 consecutive patients <18 years for 716 different substrates were tracked, with accessory pathways = 439 (61.3%) and atrioventricular nodal reentry tachycardia (AVNRT) = 205 (28.6%) being most frequent. Incidence of RFCA reached 0.049 per 1000 children <18 years of age in the recent era (2006–10). Indications included patient preference (68.0%), drug refractoriness (15.5%), asymptomatic Wolff–Parkinson–White pre-excitation (8.4%), and malignant arrhythmia (6.1%). Median follow-up was 13.7 (interquartile range 5.7–21.5) months. Overall acute/long-term success of the primary procedure was 89.1/77.2% (accessory pathways 87.2/77.7%, AVNRT 98.5/84.4%). Re-ablation was performed in 73 of 163 substrates after a primary unsuccessful ablation resulting in a long-term cumulative efficacy of 96.3%. Between 1993–2005 and 2006–10, procedure/fluoroscopy time decreased from median 154/24 to 105/14 min. (P < 0.001 for both). Serious complications occurred in nine patients (1.4%). Conclusion: This population-based study could replicate data from previous single- or multi-centre reports confirming RFCA as a safe method of arrhythmia treatment in children with long-term cumulative efficacy exceeding 90% and significant decrease in the procedure and fluoroscopy time during the study period. The need for RFCA can be estimated at 0.05/1000 children <18 years using current indication criteria.