Key result
Catheter ablation achieves ~85% long-term arrhythmia control in pediatric arrhythmia-induced cardiomyopathy.
Why the study?
Because cardiomyopathy subtypes can overlap and prior slow tachycardia is frequently undocumented at presentation, arrhythmia-induced cardiomyopathy is often diagnosed only retrospectively, motivating assessment of ablation outcomes and final diagnoses in pediatric patients.
Does catheter ablation improve left ventricular function and provide long-term arrhythmia control in pediatric patients with presumed arrhythmia-induced cardiomyopathy?
Cohort (n=20)
No
Does catheter ablation improve left ventricular function and provide long-term arrhythmia control in pediatric patients with presumed arrhythmia-induced cardiomyopathy?
In pediatric patients with arrhythmia-induced cardiomyopathy, including those requiring mechanical circulatory support, catheter ablation achieves an 85% overall success rate and leads to sustained normalization of ventricular function in 95% of cases over long-term follow-up.
Answers are grounded in this paper and cite their sources.
May support ablation for arrhythmia control in pediatric AICM; leaves open confirmation in prospective trials.
Background: Arrhythmia induced cardiomyopathy (AiCM) is reversible, and catheter ablation has become the standard treatment for most arrhythmias. Given the potential overlap between different forms of cardiomyopathy and the frequent absence of documentation of slow tachycardia before first presentation, the diagnosis of AiCM can often made only in retrospective. Methods: A single center retrospective study including patients who had ablation for presumed AiCM after January 2011 to assess the outcomes of ablation, and the final diagnosis. Patient demographics, types of arrhythmias, procedural details and follow up data were obtained from medical records. Results: 20 patients (10 female) were included in the study with the following distribution of arrhythmias: Atrial Ectopic Tachycardia (AET) = 8, Permanent Junctional Reciprocating Tachycardia (PJRT) = 6, Ventricular Tachycardia = 3, Premature Ventricular Contraction = 1, Atrial Flutter = 1, Atrioventricular Reciprocating Tachycardia = 1. 13/20 (65%) had successful primary ablation resulting in recovery of function and/or discontinuation of antiarrhythmic medication. In 8/20 (20%) ablation was performed under mechanical circulatory support, 3/20 (15%) had arrhythmia recurrence. Overall long-term control of arrhythmia with ablation alone was achieved in 17/20 (85%). One AET patient showed no recovery of function despite successful ablation, consequently requiring heart transplant due to later confirmed gene-positive cardiomyopathy. Overall, 19 patients (95%) showed normal cardiac function at the end of study period with diagnosis of AiCM. There was one significant complication with AV block due to RF ablation on ECMO in a newborn with PJRT. Conclusions: When carefully selected, ablation for pediatric patients in AICM has a high success rate including long term recovery of the ventricular function, even for small patients. Very rarely ventricular function will not recover despite successful ablation as genetic cardiomyopathies can present with secondary arrhythmia.
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Doi et al. (2026) conducted a cohort in Presumed arrhythmia-induced cardiomyopathy (AiCM) (n=20). Catheter ablation was evaluated on Overall long-term control of arrhythmia with catheter ablation (elimination of documented arrhythmia resulting in LV functional recovery and/or discontinuation of antiarrhythmic medication). Catheter ablation achieved overall long-term arrhythmia control in 85% (17/20) of pediatric patients with presumed arrhythmia-induced cardiomyopathy, with 95% (19/20) maintaining normal LVEF.
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