Anne M Dubin1, Neal W Jorgensen2, Andrew E Radbill3, David J Bradley4, Jennifer N Silva5, Sabrina Tsao6, Ronald J Kanter7, Ronn E Tanel8, Bhavya Trivedi9, Ming-Lon Young10, Andreas Pflaumer11, Jorge McCormack12, Stephen P Seslar13. 1. Division of Pediatric Cardiology, Department of Pediatrics, Lucile Packard Children's Hospital at Stanford, Stanford University, Palo Alto, California. Electronic address: amdubin@stanford.edu. 2. Department of Biostatistics, University of Washington, Seattle, Washington. 3. Division of Pediatric Cardiology, Department of Pediatrics, Vanderbilt University, Nashville, Tennessee. 4. Division of Pediatric Cardiology, Department of Pediatrics, CS Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan. 5. Division of Pediatric Cardiology, Department of Pediatrics, Washington University, St Louis, Missouri. 6. Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois. 7. Nicklaus Children's Hospital, Miami, Florida. 8. Division of Pediatric Cardiology, Department of Pediatrics, UCSF Benioff Children's Hospital UCSF School of Medicine, San Francisco, California. 9. Florida Hospital for Children, Orlando, Florida. 10. Joe DiMaggio Children's Hospital, Hollywood, Florida. 11. Royal Children's Hospital, MCRI and University of Melbourne, Melbourne, Australia. 12. St Joseph's Children Hospital Tampa and University of South Florida, Tampa, Florida. 13. Division of Pediatric Cardiology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington.
Abstract
BACKGROUND: Since the onset of pediatric catheter ablation, the pediatric electrophysiology community has reported outcomes via various registries (PAPCA [Prospective Assessment After Pediatric Cardiac Ablation], PCAR [Pediatric Catheter Ablation Registry]). Most recently, a modern era pediatric and congenital ablation registry (MAP-IT [Multicenter Pediatric and Congenital EP Quality Initiative]) was developed for eventual incorporation into the National Cardiovascular Data Registry (NCDR) IMPACT (Improving Pediatric and Adult Congenital Treatment) registry. OBJECTIVE: The purpose of this study was to describe initial findings from the MAP-IT pilot registry and to compare these findings to earlier registries. METHODS: Before entering the NCDR IMPACT registry, MAP-IT was active at 12 centers (11 in the United States) between October 2014 and April 2016. All electrophysiological studies for patients younger than 21 years and for patients of all ages with structural congenital heart disease were included. We compared the acute success, fluoroscopy and procedural times, and frequency of complications between MAP-IT and the earlier registries. RESULTS: Acute success rates have improved from the initial PCAR registry for both accessory and slow pathway substrates. Both fluoroscopy and procedural times have significantly decreased across the time periods (fluoroscopy time 47.6 ± 40 minutes to 7.0 ± 9.2 minutes; P <.001; procedural time 257 ± 157 minutes to 166 ± 84 minutes; P <.001). CONCLUSION: Acute success rates and fluoroscopy and procedural times in pediatric ablation all have improved over the last 25 years.
BACKGROUND: Since the onset of pediatric catheter ablation, the pediatric electrophysiology community has reported outcomes via various registries (PAPCA [Prospective Assessment After Pediatric Cardiac Ablation], PCAR [Pediatric Catheter Ablation Registry]). Most recently, a modern era pediatric and congenital ablation registry (MAP-IT [Multicenter Pediatric and Congenital EP Quality Initiative]) was developed for eventual incorporation into the National Cardiovascular Data Registry (NCDR) IMPACT (Improving Pediatric and Adult Congenital Treatment) registry. OBJECTIVE: The purpose of this study was to describe initial findings from the MAP-IT pilot registry and to compare these findings to earlier registries. METHODS: Before entering the NCDR IMPACT registry, MAP-IT was active at 12 centers (11 in the United States) between October 2014 and April 2016. All electrophysiological studies for patients younger than 21 years and for patients of all ages with structural congenital heart disease were included. We compared the acute success, fluoroscopy and procedural times, and frequency of complications between MAP-IT and the earlier registries. RESULTS: Acute success rates have improved from the initial PCAR registry for both accessory and slow pathway substrates. Both fluoroscopy and procedural times have significantly decreased across the time periods (fluoroscopy time 47.6 ± 40 minutes to 7.0 ± 9.2 minutes; P <.001; procedural time 257 ± 157 minutes to 166 ± 84 minutes; P <.001). CONCLUSION: Acute success rates and fluoroscopy and procedural times in pediatric ablation all have improved over the last 25 years.
Authors: Christopher M Janson; Maully J Shah; Kevin F Kennedy; V Ramesh Iyer; Tammy L Sweeten; Andrew C Glatz; James M Steven; Michael L O'Byrne Journal: Circ Arrhythm Electrophysiol Date: 2021-06-17