Outcomes From Pediatric Ablation

Walsh, Mark A.; Gonzalez, Cecilia M.; Uzun, Orhan; McMahon, Colin J.; Sadagopan, Shankar; Yue, Arthur M.; Seller, Neil; Hares, Dominic; Bhole, Vinay; Till, Jan; Wong, Leonie C.H.; Mangat, Jasveer; Rosenthal, Éric; Bowes, Michael; Stuart, Graham

doi:10.1016/j.jacep.2021.03.012

Cited by 16 publications

(12 citation statements)

References 17 publications

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“…6 ) [ 3 ]. About 1.6% of patients with AVRT have structural cardiovascular disease [ 4 ]. Ebstein anomaly often leads to the development of multiple APs and requires special considerations in management [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Case report: Antidromic atrioventricular reentrant tachycardia and underlying Ebstein anomaly

Nazari,

Dapas,

Pacak

et al. 2024

Heliyon

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Section: Discussionmentioning

confidence: 99%

Case report: Antidromic atrioventricular reentrant tachycardia and underlying Ebstein anomaly

Nazari,

Dapas,

Pacak

et al. 2024

Heliyon

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“…Overall, the risk of significant complications related to ablation procedures is fortunately quite low, but one cannot overstate the potential impact on patient morbidity. A recent publication from a United Kingdom pediatric registry over a 20‐year period reported only 12 documented cases of heart block (0.002%) related to the ablation procedure 3 though earlier pediatric reports documented higher rates (1.2%) of atrioventricular block with radiofrequency ablation 4 . All of the cases of heart block were due to radiofrequency ablation injury and 7/12 cases were related to an AVNRT substrate.…”

Section: Discussionmentioning

confidence: 99%

In‐vivo evaluation of catheter integrity with the use of a novel catheter torque tool

Mass,

Opfermann,

Grupposo

et al. 2023

Cardiovasc electrophysiol

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IntroductionElectrophysiology studies and ablation procedures require strength, steadiness, and dexterity to manipulate catheters. We have previously described a novel catheter torque tool (Peritorq) that improves torqueability and stability and decreases user muscle fatigue. The objective was to evaluate measures of catheter integrity with and without the torque tool in place using multiple diagnostic and ablation catheters in an adult porcine model.MethodsDiagnostic and ablation catheters were inserted through the femoral or jugular vein into areas of the right atrium, coronary sinus (CS), and right ventricle. Electrical measurements including impedance, sensing, and capture thresholds were obtained with and without the torque tool. Ablation lesions (30 s) were given at different locations using both irrigated and nonirrigated catheters and measurements were recorded with and without the torque tool.ResultsProcedures were performed in eight adult pigs. Measurements with and without the torque tool in all locations did not differ significantly using any of the catheters. With the nonirrigated ablation catheter there was a significant difference in maximum (mean 1.7 W, p = .03) and average power (mean 9.1 W, p = .04) delivery at the PS tricuspid valve, but there were no other differences with the irrigated or nonirrigated catheters. Subjective assessment by the operator revealed a substantial improvement in maneuverability, ability to transfer torque, and stability within the cardiac space.ConclusionIn an in‐vivo environment, a novel catheter torque tool subjectively improved catheter manipulation and did not have a significant impact on the integrity of electrophysiologic catheters. Further study including additional catheters and in‐vivo human testing is indicated.

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“…Ablation therapy can be an important component of long-term management of PSVT in children . A prospective cohort study including 481 pediatric patients showed that the overall acute success rate of radiofrequency ablation for PSVT was 97.8% .…”

Section: Practical Considerations and Application Of Evidence In Spec...mentioning

confidence: 99%

Diagnosis and Management of Paroxysmal Supraventricular Tachycardia

Peng,

Zei

2024

JAMA

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ImportanceParoxysmal supraventricular tachycardia (PSVT), defined as tachyarrhythmias that originate from or conduct through the atria or atrioventricular node with abrupt onset, affects 168 to 332 per 100 000 individuals. Untreated PSVT is associated with adverse outcomes including high symptom burden and tachycardia-mediated cardiomyopathy.ObservationsApproximately 50% of patients with PSVT are aged 45 to 64 years and 67.5% are female. Most common symptoms include palpitations (86%), chest discomfort (47%), and dyspnea (38%). Patients may rarely develop tachycardia-mediated cardiomyopathy (1%) due to PSVT. Diagnosis is made on electrocardiogram during an arrhythmic event or using ambulatory monitoring. First-line acute therapy for hemodynamically stable patients includes vagal maneuvers such as the modified Valsalva maneuver (43% effective) and intravenous adenosine (91% effective). Emergent cardioversion is recommended for patients who are hemodynamically unstable. Catheter ablation is safe, highly effective, and recommended as first-line therapy to prevent recurrence of PSVT. Meta-analysis of observational studies shows single catheter ablation procedure success rates of 94.3% to 98.5%. Evidence is limited for the effectiveness of long-term pharmacotherapy to prevent PSVT. Nonetheless, guidelines recommend therapies including calcium channel blockers, β-blockers, and antiarrhythmic agents as management options.Conclusion and RelevanceParoxysmal SVT affects both adult and pediatric populations and is generally a benign condition. Catheter ablation is the most effective therapy to prevent recurrent PSVT. Pharmacotherapy is an important component of acute and long-term management of PSVT.

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Outcomes From Pediatric Ablation

Cited by 16 publications

References 17 publications

Case report: Antidromic atrioventricular reentrant tachycardia and underlying Ebstein anomaly

Case report: Antidromic atrioventricular reentrant tachycardia and underlying Ebstein anomaly

In‐vivo evaluation of catheter integrity with the use of a novel catheter torque tool

Diagnosis and Management of Paroxysmal Supraventricular Tachycardia

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