Population-based single-center outcome for pediatric catheter ablation of common supraventricular tachycardias

Abstract

Background: Catheter ablation has become the preferred treatment for common supraventricular tachycardia (SVT) in children and adolescents, but long-term follow-up data on pediatric patients remain limited.

Methods: To provide follow-up data, we created a population-based prospective pediatric catheter ablation registry in 1997. All patients underwent clinical follow-up at 1 month and 1 year after the procedure. The follow-up data were completed with a single questionnaire in 2010.

Results: Of 318 patients, 289 (91%) required one to three procedures for successful ablation. A total of 211 (66%) patients had an accessory pathway, 97 (31%) atrioventricular nodal reentrant tachycardia, and 10 (3%) atrial tachycardia. Two (0.6%) of the 318 patients had serious complications: the first had a complete atrioventricular block and required a pacemaker, while the second had a hemopericardium, which was treated with drainage. A successful ablation procedure was followed by a recurrence in 18 (6%) patients during childhood. In addition, two patients had atrial fibrillation and one had a focal atrial tachycardia as adults after a successful ablation procedure during childhood. Moreover, 12 (4%) patients, who had undergone a successful ablation, complained of increased heart rate after exercise compared to their status before the procedure.

Conclusion: In our cohort study of 318 pediatric patients, with a mean follow-up of 5 years, SVT ablation was successful for 91% of the patients. Arrhythmia recurred in 6% of the patients. The increased sinus rate following radiofrequency ablation, observed in 4% of pediatric patients, constitutes a new finding, which warrants attention in other patient series.

Keywords: ablation; pediatrics.