A Cohort Study on Prognostic Factors for Long-Term Success after Catheter Ablation of Supraventricular Tachycardia in Children

INTRODUCTION: Radiofrequency catheter ablation (RFCA) is an established therapy for pediatric supraventricular tachycardia (SVT). However, data on long-term outcomes and predictors of success from sizable contemporary cohorts are limited. This study aimed to evaluate the long-term clinical success rate of RFCA in a pediatric cohort and to identify independent predictors of arrhythmia-free survival. METHODS: We conducted a retrospective analysis of 219 consecutive pediatric patients (age ≤18 years) who underwent their first RFCA for SVT (including atrioventricular reentrant tachycardia, atrioventricular nodal reentrant tachycardia, and atrial tachycardia) at a single tertiary center over a 6-year period. The primary outcome was long-term clinical success, defined as acute procedural success without clinical recurrence during follow-up. Univariable and multivariable logistic regression analyses were performed to identify factors associated with long-term success. RESULTS: The overall acute procedural success rate was 96.3% (211/219, excluding 3 with non-inducible SVT and 5 acute failures from the denominator). The long-term clinical success rate was 91.3% (based on 200/219 patients). Multivariable analysis identified older age as a significant independent predictor of long-term success (p = 0.016). Furthermore, atrial tachycardia was associated with a lower odd of success compared to atrioventricular nodal reentrant tachycardia, although the difference was not statistically significant. CONCLUSION: RFCA is highly effective for treating pediatric SVT, with excellent long-term durability. Older age at procedure is a strong independent predictor of success, while patients with AT may have a higher risk of recurrence. These findings are valuable for pre-procedural counseling and patient selection.