Pediatric Radiofrequency Catheter Ablation Registry success, fluoroscopy time, and complication rate for supraventricular tachycardia: Comparison of early and recent eras

John Dale Kugler, David Alan Danford, Kris A. Houston, Gary Felix

Research output: Contribution to journalArticle

202 Citations (Scopus)

Abstract

Introduction: To assess changes of success rate, fluoroscopy time, and complication rate for six supraventricular tachycardia pathways/mechanisms, data from the Pediatric Radiofrequency Catheter Ablation Registry were grouped into two eras (1991-1995; 1996-1999). Methods and Results: Data from the early era and the late era were compared using the Chi-square test for the outcomes of success rate and complication rate and using the Student's t-test for the outcome of mean fluoroscopy time. In the Registry as a whole, ablation failure rates fell from 9.6% in the early era to 4.8% in the recent era, a reduction of 50% overall. Improved success rates were found for posterior septal, right free-wall, and left free-wall pathways and for AV nodal reentry, whereas anterior septal pathways and atrial ectopic-focus tachycardia did not show improvement. Mean fluoroscopy time overall decreased 21% from 50.9 ± 39.9 minutes to 40.1 ± 35.1 minutes. Individually, the improvement in fluoroscopy time was found for all but the atrial ectopic-focus tachycardia mechanism. The complication rate decreased from 4.2% to 3.0%, with significant decreases for left free-wall and posterior septal pathways. Conclusion: Patient selection strategies to optimize radiofrequency ablation outcomes in children, which have been based on the previously published Registry data, should be reconsidered in light of these new, updated data. The lack of uniform improvement provides the impetus for further research and development of new approaches and technologic advances so that further improvement can be achieved.

Original languageEnglish (US)
Pages (from-to)336-341
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume13
Issue number4
DOIs
StatePublished - Jan 1 2002

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Supraventricular Tachycardia
Catheter Ablation
Fluoroscopy
Registries
Ectopic Atrial Tachycardia
Pediatrics
Chi-Square Distribution
Patient Selection
Students
Research

Keywords

  • Pediatric radiofrequency catheter ablation fluoroscopy time
  • Pediatric radiofrequency catheter ablation success rate

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

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title = "Pediatric Radiofrequency Catheter Ablation Registry success, fluoroscopy time, and complication rate for supraventricular tachycardia: Comparison of early and recent eras",
abstract = "Introduction: To assess changes of success rate, fluoroscopy time, and complication rate for six supraventricular tachycardia pathways/mechanisms, data from the Pediatric Radiofrequency Catheter Ablation Registry were grouped into two eras (1991-1995; 1996-1999). Methods and Results: Data from the early era and the late era were compared using the Chi-square test for the outcomes of success rate and complication rate and using the Student's t-test for the outcome of mean fluoroscopy time. In the Registry as a whole, ablation failure rates fell from 9.6{\%} in the early era to 4.8{\%} in the recent era, a reduction of 50{\%} overall. Improved success rates were found for posterior septal, right free-wall, and left free-wall pathways and for AV nodal reentry, whereas anterior septal pathways and atrial ectopic-focus tachycardia did not show improvement. Mean fluoroscopy time overall decreased 21{\%} from 50.9 ± 39.9 minutes to 40.1 ± 35.1 minutes. Individually, the improvement in fluoroscopy time was found for all but the atrial ectopic-focus tachycardia mechanism. The complication rate decreased from 4.2{\%} to 3.0{\%}, with significant decreases for left free-wall and posterior septal pathways. Conclusion: Patient selection strategies to optimize radiofrequency ablation outcomes in children, which have been based on the previously published Registry data, should be reconsidered in light of these new, updated data. The lack of uniform improvement provides the impetus for further research and development of new approaches and technologic advances so that further improvement can be achieved.",
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T2 - Comparison of early and recent eras

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AU - Houston, Kris A.

AU - Felix, Gary

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N2 - Introduction: To assess changes of success rate, fluoroscopy time, and complication rate for six supraventricular tachycardia pathways/mechanisms, data from the Pediatric Radiofrequency Catheter Ablation Registry were grouped into two eras (1991-1995; 1996-1999). Methods and Results: Data from the early era and the late era were compared using the Chi-square test for the outcomes of success rate and complication rate and using the Student's t-test for the outcome of mean fluoroscopy time. In the Registry as a whole, ablation failure rates fell from 9.6% in the early era to 4.8% in the recent era, a reduction of 50% overall. Improved success rates were found for posterior septal, right free-wall, and left free-wall pathways and for AV nodal reentry, whereas anterior septal pathways and atrial ectopic-focus tachycardia did not show improvement. Mean fluoroscopy time overall decreased 21% from 50.9 ± 39.9 minutes to 40.1 ± 35.1 minutes. Individually, the improvement in fluoroscopy time was found for all but the atrial ectopic-focus tachycardia mechanism. The complication rate decreased from 4.2% to 3.0%, with significant decreases for left free-wall and posterior septal pathways. Conclusion: Patient selection strategies to optimize radiofrequency ablation outcomes in children, which have been based on the previously published Registry data, should be reconsidered in light of these new, updated data. The lack of uniform improvement provides the impetus for further research and development of new approaches and technologic advances so that further improvement can be achieved.

AB - Introduction: To assess changes of success rate, fluoroscopy time, and complication rate for six supraventricular tachycardia pathways/mechanisms, data from the Pediatric Radiofrequency Catheter Ablation Registry were grouped into two eras (1991-1995; 1996-1999). Methods and Results: Data from the early era and the late era were compared using the Chi-square test for the outcomes of success rate and complication rate and using the Student's t-test for the outcome of mean fluoroscopy time. In the Registry as a whole, ablation failure rates fell from 9.6% in the early era to 4.8% in the recent era, a reduction of 50% overall. Improved success rates were found for posterior septal, right free-wall, and left free-wall pathways and for AV nodal reentry, whereas anterior septal pathways and atrial ectopic-focus tachycardia did not show improvement. Mean fluoroscopy time overall decreased 21% from 50.9 ± 39.9 minutes to 40.1 ± 35.1 minutes. Individually, the improvement in fluoroscopy time was found for all but the atrial ectopic-focus tachycardia mechanism. The complication rate decreased from 4.2% to 3.0%, with significant decreases for left free-wall and posterior septal pathways. Conclusion: Patient selection strategies to optimize radiofrequency ablation outcomes in children, which have been based on the previously published Registry data, should be reconsidered in light of these new, updated data. The lack of uniform improvement provides the impetus for further research and development of new approaches and technologic advances so that further improvement can be achieved.

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