Scott R Ceresnak1, Anne M Dubin1, Jeffrey J Kim2, Santiago O Valdes2, Steven B Fishberger3, Ira Shetty4, Frank Zimmerman4, Ronn E Tanel5, Michael R Epstein6, Kara S Motonaga1, Christine A Capone7, Lynn Nappo7, Gregory J Gates7, Robert H Pass7. 1. Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University, Palo Alto, California, USA. 2. Department of Pediatric Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA. 3. Department of Pediatrics, Miami Children's Hospital, Miami, Florida, USA. 4. Department of Pediatrics, Advocate Children's Hospital, Oak Lawn, Illinois, USA. 5. Department of Pediatrics, UCSF School of Medicine, UCSF Benioff Children's Hospital, San Francisco, California, USA. 6. Department of Pediatrics, Maine Medical Center, Portland, Maine, USA. 7. Department of Pediatrics, Albert Einstein College of Medicine, The Children's Hospital at Montefiore, Bronx, New York, USA.
Abstract
INTRODUCTION: Three-dimensional mapping (3-D) systems are frequently used for ablation of supraventricular tachycardia. Prior studies have demonstrated radiation dosage reduction with 3-D, but there are no data on whether 3-D improves the efficacy of ablation of Wolff-Parkinson-White syndrome (WPW). We sought to determine if 3-D improves the success rate for ablation of WPW in children. METHODS: Multicenter retrospective study including patients ≤21 years of age with WPW undergoing ablation from 2008 to 2012. Success rates using the 2 techniques (3-D vs. fluoroscopy alone [FLUORO]) were compared. RESULTS: Six hundred and fifty-one cases were included (58% male, mean age 13 ± 4 years, 366 [56%] 3-D). Baseline characteristics including gender, weight, accessory pathway (AP) location, number of APs, and repeat ablation attempts were similar between the 2 groups (3-D and FLUORO) The 3-D group was slightly younger (12.7 ± 4.0 vs. 13.3 ± 4.0 years; P = 0.04) and less likely to undergo ablation utilizing cryoenergy (38 [10%] vs. 56 [20%]; P < 0.01). The 3-D group had a higher acute success rate of ablation (355 [97%] vs. 260 [91%]; P < 0.01). No differences were seen in recurrence (16 [5%] vs. 26 [9%]; P = 0.09) or complication rates (1 [0.3%] vs. 1 [0.4%]; P = 0.86) between the groups. On multivariable analysis, 3-D was shown to significantly improve success at ablation with an odds ratio of 3.1 (95% CI 1.44-6.72; P < 0.01). CONCLUSIONS: Use of 3-D significantly improved success rates for ablation of WPW in children. The increase in acute success associated with 3-D suggests it is an important adjunct for catheter ablation of WPW in children.
INTRODUCTION: Three-dimensional mapping (3-D) systems are frequently used for ablation of supraventricular tachycardia. Prior studies have demonstrated radiation dosage reduction with 3-D, but there are no data on whether 3-D improves the efficacy of ablation of Wolff-Parkinson-White syndrome (WPW). We sought to determine if 3-D improves the success rate for ablation of WPW in children. METHODS: Multicenter retrospective study including patients ≤21 years of age with WPW undergoing ablation from 2008 to 2012. Success rates using the 2 techniques (3-D vs. fluoroscopy alone [FLUORO]) were compared. RESULTS: Six hundred and fifty-one cases were included (58% male, mean age 13 ± 4 years, 366 [56%] 3-D). Baseline characteristics including gender, weight, accessory pathway (AP) location, number of APs, and repeat ablation attempts were similar between the 2 groups (3-D and FLUORO) The 3-D group was slightly younger (12.7 ± 4.0 vs. 13.3 ± 4.0 years; P = 0.04) and less likely to undergo ablation utilizing cryoenergy (38 [10%] vs. 56 [20%]; P < 0.01). The 3-D group had a higher acute success rate of ablation (355 [97%] vs. 260 [91%]; P < 0.01). No differences were seen in recurrence (16 [5%] vs. 26 [9%]; P = 0.09) or complication rates (1 [0.3%] vs. 1 [0.4%]; P = 0.86) between the groups. On multivariable analysis, 3-D was shown to significantly improve success at ablation with an odds ratio of 3.1 (95% CI 1.44-6.72; P < 0.01). CONCLUSIONS: Use of 3-D significantly improved success rates for ablation of WPW in children. The increase in acute success associated with 3-D suggests it is an important adjunct for catheter ablation of WPW in children.
Authors: Marta Telishevska; J Hebe; T Paul; J H Nürnberg; U Krause; R Gebauer; M Gass; C Balmer; F Berger; S Molatta; M Emmel; W Lawrenz; T Kriebel; G Hessling Journal: Clin Res Cardiol Date: 2018-12-05 Impact factor: 5.460
Authors: Ari J Gartenberg; Robert H Pass; Scott Ceresnak; Lynn Nappo; Christopher M Janson Journal: Pediatr Cardiol Date: 2018-10-12 Impact factor: 1.655
Authors: Christopher M Janson; Hannah H Nam; Christian Herz; Andras Lasso; Alana Cianciulli; Matthew A Jolley Journal: J Cardiovasc Electrophysiol Date: 2020-08-26
Authors: Scott R Ceresnak; Robert H Pass; Anne M Dubin; Lingyao Yang; Kara S Motonaga; Haley Hedlin; Kishor Avasarala; Anthony Trela; Doff B McElhinney; Christopher Janson; Lynn Nappo; Xuefeng B Ling; Gregory J Gates Journal: PLoS One Date: 2019-06-26 Impact factor: 3.240