Journal article
Catheter ablation in ASymptomatic PEDiatric patients with ventricular preexcitation: results from the multicenter "CASPED" study.
- Telishevska M Department of Electrophysiology, German Heart Center Munich, Munich, Germany. martat77@gmail.com.
- Hebe J Center f. Electrophysiology Bremen, Bremen, Germany.
- Paul T Pediatric Cardiology and Intensive Care Medicine, Georg August University Goettingen, Goettingen, Germany.
- Nürnberg JH Center f. Electrophysiology Bremen, Bremen, Germany.
- Krause U Pediatric Cardiology and Intensive Care Medicine, Georg August University Goettingen, Goettingen, Germany.
- Gebauer R Pediatric Cardiology, Heart Center, University of Leipzig, Leipzig, Germany.
- Gass M Electrophysiology, Lake Constance Heart Center, Constance, Germany.
- Balmer C Pediatric Cardiology, University Children's Hospital Zurich, Zurich, Switzerland.
- Berger F Pediatric Cardiology, University Children's Hospital Zurich, Zurich, Switzerland.
- Molatta S Clinic for Cardiology, Herz-und Diabeteszentrum NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany.
- Emmel M Pediatric Cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany.
- Lawrenz W Clinic for Pediatric Cardiology, Heart Center Duisburg, Duisburg, Germany.
- Kriebel T Pediatric Cardiology, Westpfalz-Klinikum, Kaiserslautern, Germany.
- Hessling G Department of Electrophysiology, German Heart Center Munich, Munich, Germany.
- 2018-12-07
Published in:
- Clinical research in cardiology : official journal of the German Cardiac Society. - 2019
Accessory pathways
Catheter ablation
Ventricular preexcitation
Accessory Atrioventricular Bundle
Action Potentials
Adolescent
Age Factors
Asymptomatic Diseases
Catheter Ablation
Child
Cryosurgery
Female
Germany
Heart Rate
Humans
Male
Recurrence
Retrospective Studies
Risk Factors
Switzerland
Time Factors
Treatment Outcome
Wolff-Parkinson-White Syndrome
English
BACKGROUND
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.
METHODS AND RESULTS
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%.
CONCLUSION
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.
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.
METHODS AND RESULTS
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%.
CONCLUSION
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.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1007/s00392-018-1397-x
- PMID 30519781
- Persistent URL
- https://folia.unifr.ch/global/documents/298807
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