Prospective assessment after pediatric cardiac ablation: Recurrence at 1 year after initially successful ablation of supraventricular tachycardia

George F. Van Hare, Harold Javitz, Dorit Carmelli, J. Philip Saul, Ronn E. Tanel, Peter S. Fischbach, Ronald J. Kanter, Michael Schaffer, Ann Dunnigan, Steven Colan, Gerald Serwer, Macdonald Dick, Robert Campbell, Yung R. Lau, Edward P. Walsh, Timothy Knilans, William Scott, Jeanny Park, Peter Karpawich, Margaret BellRichard Friedman, Steven Weindling, Christopher Erickson, Ruchir Sehra, Kevin M. Shannon, Ming Lon Young, Frank Fish, Steven Fishberger, Bertrand Ross, John Kugler, Anne M. Dubin, Mary Sokoloski, Lee Beerman, Marc LeGras, Seshadri Balaji, Coburn Porter, Susan Etheridge, James C. Perry, Frank Cecchin, Frank Zimmerman, Burt Bromberg, Craig Byrum, Ricardo Samson, Robert Hamilton, Jeff Moak

Research output: Contribution to journalArticle

113 Scopus citations

Abstract

Objectives. A multicenter prospective study was performed to assess the results and risks associated with radiofrequency ablation in children. This report focuses on recurrences following initially successful ablation. Methods. Patients recruited for the study were aged 0 to 16 years and had supraventricular tachycardia due to accessory pathways or atrioventricular nodal reentrant tachycardia (AVNRT), excluding patients with more than trivial congenital heart disease. A total of 481 patients were recruited into the prospective cohort and were followed at 2, 6, and 12 months following ablation. Results. There were 517 successfully ablated substrates out of 540 attempted (95.7%). Loss to follow-up for individual substrates was 3.3%, 10.6%, and 21.2% at 2, 6, and 12 months, respectively. Recurrence was observed in 7.0%, 9.2%, and 10.7% of these substrates at 2, 6, and 12 months, respectively (adjusted for loss to follow-up as an independent source of data censoring). Recurrence rate varied by substrate location (24.6% for right septal, 15.8% for right free wall, 9.3% for left free wall, and 4.8% for left septal), as well as for AVNRT versus all others (4.8% vs 12.9%) at 12 months. The recurrence rate was higher for substrates ablated using power control but was not a function of whether isoproterenol was used for postablation testing. Conclusions. Recurrence after initially successful ablation occurs commonly in children. It is least common after AVNRT ablation and most common following ablation of right-sided pathways. These results serve as a benchmark for the time course of recurrence following initially successful ablation of supraventricular tachycardia in children.

Original languageEnglish (US)
Pages (from-to)188-196
Number of pages9
JournalHeart Rhythm
Volume1
Issue number2
DOIs
StatePublished - Jul 2004

Keywords

  • Ablation
  • Atrioventricular nodal reentry
  • Children
  • Recurrence
  • Registry
  • Wolff-Parkinson-White syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Van Hare, G. F., Javitz, H., Carmelli, D., Saul, J. P., Tanel, R. E., Fischbach, P. S., Kanter, R. J., Schaffer, M., Dunnigan, A., Colan, S., Serwer, G., Dick, M., Campbell, R., Lau, Y. R., Walsh, E. P., Knilans, T., Scott, W., Park, J., Karpawich, P., ... Moak, J. (2004). Prospective assessment after pediatric cardiac ablation: Recurrence at 1 year after initially successful ablation of supraventricular tachycardia. Heart Rhythm, 1(2), 188-196. https://doi.org/10.1016/j.hrthm.2004.03.067