Journal
EUROPACE
Volume 23, Issue 3, Pages 431-440Publisher
OXFORD UNIV PRESS
DOI: 10.1093/europace/euaa325
Keywords
Supraventricular tachycardia; Ventricular tachycardia; Radiofrequency ablation; Children; Cryoenergy; Registry
Categories
Funding
- Medtronic (Medtronic International Trading Sa`rl, Tolochenaz, Switzerland)
- Ministry of Health, Czech Republic [00064203]
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This study demonstrates overall high efficacy and safety of catheter ablation for different tachycardia substrates in pediatric patients, with exceptionally low complication rate. Long-term success rate is high, except for patients after VT ablation.
Aims Contemporary data from prospective multicentre registries on catheter ablation in pediatric patients are sparse. Aim of the European Pediatric Catheter Ablation Registry EUROPA was to contribute data to fill this gap of knowledge. Methods and results From July 2012 to June 2017, data on catheter ablation in pediatric patients (<= 18 years of age) including a 1-year follow-up from five European pediatric EP centres were collected prospectively. A total of 683 patients (mean age 12.4 +/- 3.9 years, mean body weight 50.2 +/- 19 kg) were enrolled. Target tachycardia was WPW/atrioventricular-nodal re-entrant tachycardia (AVRT) in 380 (55.7%) patients, AVNRT in 230 (33.8%) patients, ventricular tachycardia (VT) in 24 (3.5) patients, focal atrial tachycardia (FAT) in 20 (2.9%) patients, IART in 14 (2%) patients, and junctional ectopic tachycardia in 3 (0.45) patients. Overall procedural success was 95.6%. Compared with all other substrates, success was significantly lower in FAT patients (80%, n=16, P= 0.001). Mean procedure duration was 136 +/- 67 min and mean fluoroscopy time was 4.9 +/- 6.8 min. Major complications occurred in 0.7% of the patients. No persisting AV block requiring permanent pacing was reported. At 1-year follow-up (605/683 patients, 95%), tachycardia recurrence was reported in 7.8% of patients. Recurrence after VT ablation (33%) was significantly higher P= 0.001) than after ablation of all other substrates. Conclusion The present study proves overall high efficacy and safety of catheter ablation of various tachycardia substrates in pediatric patients. Of note, complication rate was exceptionally low. Long-term success was high except for patients after VT ablation.
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