Prospective assessment after pediatric cardiac ablation: Fate of intracardiac structure and function, as assessed by serial echocardiography

George F. Van Hare, Steven D. Colan, Harold Javitz, Dorit Carmelli, Timothy Knilans, Michael Schaffer, John Dale Kugler, Craig J. Byrum, J. Philip Saul

Research output: Contribution to journalArticle

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Abstract

Background: Catheter ablation puts cardiac valves at risk of damage, and children are of particular concern. Methods: A multicenter prospective study was performed to assess the results and risks associated with radiofrequency (RF) ablation in children. Patients were aged 0 to 16 years with supraventricular tachycardia due to accessory pathway or atrioventricular node reentry, excluding patients with more than trivial congenital heart disease. A total of 481 patients were recruited into the prospective cohort and were followed up at 2, 6 and, 12 months after ablation. Complete echocardiograms were obtained before and at intervals after RF ablation, and they were reviewed by experts who were blinded with respect to diagnosis, outcome, pathway site, and study interval. Results: Moderate valve insufficiency was quite rare (0.12%), but mild insufficiency was common, both before ablation (42.43%) and at 2 months after ablation (40.49%). Analysis of paired readings failed to demonstrate a tendency toward increased insufficiency of valves adjacent to ablation targets, with the exception of the tricuspid valve after the ablation of right freewall pathways and atrioventricular node reentry, but the degree of change was small. No clear changes in left ventricular systolic or diastolic function were observed, and dyskinesis was rare and not related to the ablation target. No intracardiac thrombosis was observed. Conclusions: Serious injury to cardiac valves due to RF ablation is very rare, but the tricuspid valve may be mildly affected in some cases. We identified no clear effect of RF ablation on cardiac wall motion or on left ventricular function.

Original languageEnglish (US)
Pages (from-to)815-820.e6
JournalAmerican Heart Journal
Volume153
Issue number5
DOIs
StatePublished - May 2007

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Echocardiography
Atrioventricular Node
Tricuspid Valve
Heart Valves
Pediatrics
Supraventricular Tachycardia
Catheter Ablation
Left Ventricular Function
Multicenter Studies
Reading
Heart Diseases
Thrombosis
Prospective Studies
Wounds and Injuries

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Prospective assessment after pediatric cardiac ablation : Fate of intracardiac structure and function, as assessed by serial echocardiography. / Van Hare, George F.; Colan, Steven D.; Javitz, Harold; Carmelli, Dorit; Knilans, Timothy; Schaffer, Michael; Kugler, John Dale; Byrum, Craig J.; Saul, J. Philip.

In: American Heart Journal, Vol. 153, No. 5, 05.2007, p. 815-820.e6.

Research output: Contribution to journalArticle

Van Hare, George F. ; Colan, Steven D. ; Javitz, Harold ; Carmelli, Dorit ; Knilans, Timothy ; Schaffer, Michael ; Kugler, John Dale ; Byrum, Craig J. ; Saul, J. Philip. / Prospective assessment after pediatric cardiac ablation : Fate of intracardiac structure and function, as assessed by serial echocardiography. In: American Heart Journal. 2007 ; Vol. 153, No. 5. pp. 815-820.e6.
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abstract = "Background: Catheter ablation puts cardiac valves at risk of damage, and children are of particular concern. Methods: A multicenter prospective study was performed to assess the results and risks associated with radiofrequency (RF) ablation in children. Patients were aged 0 to 16 years with supraventricular tachycardia due to accessory pathway or atrioventricular node reentry, excluding patients with more than trivial congenital heart disease. A total of 481 patients were recruited into the prospective cohort and were followed up at 2, 6 and, 12 months after ablation. Complete echocardiograms were obtained before and at intervals after RF ablation, and they were reviewed by experts who were blinded with respect to diagnosis, outcome, pathway site, and study interval. Results: Moderate valve insufficiency was quite rare (0.12{\%}), but mild insufficiency was common, both before ablation (42.43{\%}) and at 2 months after ablation (40.49{\%}). Analysis of paired readings failed to demonstrate a tendency toward increased insufficiency of valves adjacent to ablation targets, with the exception of the tricuspid valve after the ablation of right freewall pathways and atrioventricular node reentry, but the degree of change was small. No clear changes in left ventricular systolic or diastolic function were observed, and dyskinesis was rare and not related to the ablation target. No intracardiac thrombosis was observed. Conclusions: Serious injury to cardiac valves due to RF ablation is very rare, but the tricuspid valve may be mildly affected in some cases. We identified no clear effect of RF ablation on cardiac wall motion or on left ventricular function.",
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AU - Van Hare, George F.

AU - Colan, Steven D.

AU - Javitz, Harold

AU - Carmelli, Dorit

AU - Knilans, Timothy

AU - Schaffer, Michael

AU - Kugler, John Dale

AU - Byrum, Craig J.

AU - Saul, J. Philip

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N2 - Background: Catheter ablation puts cardiac valves at risk of damage, and children are of particular concern. Methods: A multicenter prospective study was performed to assess the results and risks associated with radiofrequency (RF) ablation in children. Patients were aged 0 to 16 years with supraventricular tachycardia due to accessory pathway or atrioventricular node reentry, excluding patients with more than trivial congenital heart disease. A total of 481 patients were recruited into the prospective cohort and were followed up at 2, 6 and, 12 months after ablation. Complete echocardiograms were obtained before and at intervals after RF ablation, and they were reviewed by experts who were blinded with respect to diagnosis, outcome, pathway site, and study interval. Results: Moderate valve insufficiency was quite rare (0.12%), but mild insufficiency was common, both before ablation (42.43%) and at 2 months after ablation (40.49%). Analysis of paired readings failed to demonstrate a tendency toward increased insufficiency of valves adjacent to ablation targets, with the exception of the tricuspid valve after the ablation of right freewall pathways and atrioventricular node reentry, but the degree of change was small. No clear changes in left ventricular systolic or diastolic function were observed, and dyskinesis was rare and not related to the ablation target. No intracardiac thrombosis was observed. Conclusions: Serious injury to cardiac valves due to RF ablation is very rare, but the tricuspid valve may be mildly affected in some cases. We identified no clear effect of RF ablation on cardiac wall motion or on left ventricular function.

AB - Background: Catheter ablation puts cardiac valves at risk of damage, and children are of particular concern. Methods: A multicenter prospective study was performed to assess the results and risks associated with radiofrequency (RF) ablation in children. Patients were aged 0 to 16 years with supraventricular tachycardia due to accessory pathway or atrioventricular node reentry, excluding patients with more than trivial congenital heart disease. A total of 481 patients were recruited into the prospective cohort and were followed up at 2, 6 and, 12 months after ablation. Complete echocardiograms were obtained before and at intervals after RF ablation, and they were reviewed by experts who were blinded with respect to diagnosis, outcome, pathway site, and study interval. Results: Moderate valve insufficiency was quite rare (0.12%), but mild insufficiency was common, both before ablation (42.43%) and at 2 months after ablation (40.49%). Analysis of paired readings failed to demonstrate a tendency toward increased insufficiency of valves adjacent to ablation targets, with the exception of the tricuspid valve after the ablation of right freewall pathways and atrioventricular node reentry, but the degree of change was small. No clear changes in left ventricular systolic or diastolic function were observed, and dyskinesis was rare and not related to the ablation target. No intracardiac thrombosis was observed. Conclusions: Serious injury to cardiac valves due to RF ablation is very rare, but the tricuspid valve may be mildly affected in some cases. We identified no clear effect of RF ablation on cardiac wall motion or on left ventricular function.

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