Catheter ablation in ASymptomatic PEDiatric patients with ventricular preexcitation: results from the multicenter 'CASPED' study

Autor: Thomas Paul, Stephan Molatta, J Hebe, Felix Berger, Thomas Kriebel, J H Nürnberg, Christian Balmer, M. Emmel, Roman Gebauer, Gabriele Hessling, Matthias Gass, Ulrich Krause, Marta Telishevska, W. Lawrenz
Přispěvatelé: University of Zurich, Telishevska, Marta
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Time Factors
Adolescent
medicine.medical_treatment
Action Potentials
Catheter ablation
610 Medicine & health
030204 cardiovascular system & hematology
Asymptomatic
Cryosurgery
2705 Cardiology and Cardiovascular Medicine
03 medical and health sciences
0302 clinical medicine
3d mapping
Heart Rate
Recurrence
Risk Factors
Internal medicine
Germany
medicine
Fluoroscopy
Humans
030212 general & internal medicine
Child
Retrospective Studies
medicine.diagnostic_test
business.industry
Age Factors
Cryoablation
General Medicine
Ablation
Accessory Atrioventricular Bundle
Catheter
Treatment Outcome
10036 Medical Clinic
Asymptomatic Diseases
Cardiology
Ventricular preexcitation
Catheter Ablation
Female
Wolff-Parkinson-White Syndrome
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Switzerland
Zdroj: Clinical research in cardiology : official journal of the German Cardiac Society. 108(6)
ISSN: 1861-0692
Popis: As there are limited data about the clinical practice of catheter ablation in asymptomatic children and adolescents with ventricular preexcitation on ECG, we performed the multicenter “CASPED” (Catheter ablation in ASymptomatic PEDiatric patients with Ventricular Preexcitation) study. In 182 consecutive children and adolescents aged between 8 and 18 years (mean age 12.9 ± 2.6 years; 65% male) with asymptomatic ventricular preexcitation, a total of 196 accessory pathways (APs) were targeted. APs were right sided (62%) or left sided (38%). The most common right-sided AP location was the posteroseptal region (38%). Ablation was performed using radiofrequency (RF) energy (93%), cryoablation (4%) or both (3%). Mean procedure time was 137.6 ± 62.0 min with a mean fluoroscopy time of 15.6 ± 13.8 min. A 3D mapping or catheter localization system was used in 32% of patients. Catheter ablation was acutely successful in 166/182 patients (91.2%). Mortality was 0% and there were no major periprocedural complications. AP recurrence was observed in 14/166 patients (8.4%) during a mean follow-up time of 19.7 ± 8.5 months. A second ablation attempt was performed in 20 patients and was successful in 16/20 patients (80%). Overall, long-term success rate was 92.3%. In this retrospective multicenter study, the outcome of catheter ablation for asymptomatic preexcitation in children and adolescents irrespective of antegrade AP conduction properties is summarized. The complication rate was low and success rate was high, the latter mainly depending on pathway location. The promising results of the study may have future impact on the ongoing risk–benefit discussion regarding catheter ablation in the setting of asymptomatic preexcitation in children and adolescents.
Databáze: OpenAIRE
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