Key Points
- To evaluate the nationwide, long-term utilization and outcomes of paediatric radiofrequency catheter ablation across an entire population.
- Retrospective review of all 708 radiofrequency catheter ablation procedures performed for 716 substrates in 633 consecutive patients aged <18 years across all three national referral centres in the Czech Republic between 1993 and 2010.
- Tracked primary substrates including accessory pathways (61.3%) and atrioventricular nodal reentry tachycardia (28.6%), over a median follow-up of 13.7 months (interquartile range 5.7–21.5).
- Overall acute and long-term success rates of the primary procedure were 89.1% and 77.2%, respectively; re-ablation in 73 of 163 failed substrates achieved a long-term cumulative efficacy of 96.3%.
- Median procedure time decreased from 154 to 105 min and fluoroscopy time dropped from 24 to 14 min between 1993–2005 and 2006–2010 (P < 0.001 for both).
- Serious complications occurred in nine patients (1.4%), while procedure incidence reached 0.049 per 1,000 children aged <18 years in the 2006–2010 era.
Structured PICO
Does radiofrequency catheter ablation provide safe and effective long-term arrhythmia treatment in children <18 years?
PPopulation633 consecutive patients <18 years of age undergoing 708 ablation procedures for 716 different arrhythmia substrates (most frequently accessory pathways and AVNRT)
IInterventionRadiofrequency catheter ablation (RFCA)
OOutcomeOverall acute and long-term success of the primary procedure
Radiofrequency catheter ablation is a safe and highly effective long-term treatment for arrhythmias in children, with cumulative efficacy exceeding 90%.