Prospective Assessment after Pediatric Cardiac Ablation: Demographics, Medical Profiles, and Initial Outcomes

Abstract

Introduction: 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. Methods and 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%). Conclusion: 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. (J Cardiovasc Electrophysiol, Vol. 15, pp. 759‐770, July 2004)