A multicenter review of ablation in the aortic cusps in young people

Minh B. Nguyen, Scott R. Ceresnak, Christopher M. Janson, Steven B. Fishberger, Barry A. Love, Andrew D. Blaufox, Kara S. Motonaga, Anne M. Dubin, Lynn Nappo, Robert H. Pass

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Abstract

Background: Ablation within the aortic cusp is safe and effective in adults. There are little data on aortic cusp ablation in the pediatric literature. We investigated the safety and efficacy of aortic cusp ablation in young patients. Methods: A retrospective, descriptive study of aortic cusp ablation in five pediatric electrophysiology centers from 2008 to 2014 was performed. All patients <21 years of age who underwent ablation in the aortic cusps were included. Factors analyzed included patient demographics, procedural details, outcomes, and complications. Results: Thirteen patients met inclusion criteria (median age 16 years [range 10-20.5] and median body surface area 1.58 m2 [range 1.12-2.33]). Substrates for ablation included: nine premature ventricular contractions or sustained ventricular tachycardia (69%), two concealed anteroseptal accessory pathways (APs) (15%), one Wolff-Parkinson-White with an anteroseptal AP (8%), and one ectopic atrial tachycardia (8%). Three-dimensional electroanatomic mapping in combination with fluoroscopy was used in 12/13 (92%) patients. Standard 4-mm-tip radiofrequency (RF) current was used in 11/13 (85%) and low-power irrigated-tip RF in 2/13 (15%). Angiography was used in 13/13 and intracardiac echocardiography was additionally utilized in 3/13 (23%). Ablation locations included: eight noncoronary (62%), three left (23%), and two right (15%) cusps. Ablation was acutely successful in all patients. At median follow-up of 20 months, there was one recurrence of PVCs (8%). There were no ablation-related complications and no valvular injuries observed. Conclusion: Arrhythmias originating from the coronary cusps in this series were successfully and safely ablated in young people without injury to the coronary arteries or the aortic valve.

Original languageEnglish (US)
JournalPACE - Pacing and Clinical Electrophysiology
DOIs
StateAccepted/In press - 2017

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Ectopic Atrial Tachycardia
Accessory Atrioventricular Bundle
Pediatrics
Ventricular Premature Complexes
Electrophysiology
Body Surface Area
Fluoroscopy
Wounds and Injuries
Ventricular Tachycardia
Aortic Valve
Polyvinyl Chloride
Echocardiography
Cardiac Arrhythmias
Coronary Vessels
Angiography
Retrospective Studies
Demography
Safety
Recurrence

Keywords

  • Ablation
  • Angiography
  • Aortic cusp
  • Pediatrics
  • SVT
  • VT

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Nguyen, M. B., Ceresnak, S. R., Janson, C. M., Fishberger, S. B., Love, B. A., Blaufox, A. D., ... Pass, R. H. (Accepted/In press). A multicenter review of ablation in the aortic cusps in young people. PACE - Pacing and Clinical Electrophysiology. https://doi.org/10.1111/pace.13126

A multicenter review of ablation in the aortic cusps in young people. / Nguyen, Minh B.; Ceresnak, Scott R.; Janson, Christopher M.; Fishberger, Steven B.; Love, Barry A.; Blaufox, Andrew D.; Motonaga, Kara S.; Dubin, Anne M.; Nappo, Lynn; Pass, Robert H.

In: PACE - Pacing and Clinical Electrophysiology, 2017.

Research output: Contribution to journalArticle

Nguyen, MB, Ceresnak, SR, Janson, CM, Fishberger, SB, Love, BA, Blaufox, AD, Motonaga, KS, Dubin, AM, Nappo, L & Pass, RH 2017, 'A multicenter review of ablation in the aortic cusps in young people', PACE - Pacing and Clinical Electrophysiology. https://doi.org/10.1111/pace.13126
Nguyen, Minh B. ; Ceresnak, Scott R. ; Janson, Christopher M. ; Fishberger, Steven B. ; Love, Barry A. ; Blaufox, Andrew D. ; Motonaga, Kara S. ; Dubin, Anne M. ; Nappo, Lynn ; Pass, Robert H. / A multicenter review of ablation in the aortic cusps in young people. In: PACE - Pacing and Clinical Electrophysiology. 2017.
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abstract = "Background: Ablation within the aortic cusp is safe and effective in adults. There are little data on aortic cusp ablation in the pediatric literature. We investigated the safety and efficacy of aortic cusp ablation in young patients. Methods: A retrospective, descriptive study of aortic cusp ablation in five pediatric electrophysiology centers from 2008 to 2014 was performed. All patients <21 years of age who underwent ablation in the aortic cusps were included. Factors analyzed included patient demographics, procedural details, outcomes, and complications. Results: Thirteen patients met inclusion criteria (median age 16 years [range 10-20.5] and median body surface area 1.58 m2 [range 1.12-2.33]). Substrates for ablation included: nine premature ventricular contractions or sustained ventricular tachycardia (69{\%}), two concealed anteroseptal accessory pathways (APs) (15{\%}), one Wolff-Parkinson-White with an anteroseptal AP (8{\%}), and one ectopic atrial tachycardia (8{\%}). Three-dimensional electroanatomic mapping in combination with fluoroscopy was used in 12/13 (92{\%}) patients. Standard 4-mm-tip radiofrequency (RF) current was used in 11/13 (85{\%}) and low-power irrigated-tip RF in 2/13 (15{\%}). Angiography was used in 13/13 and intracardiac echocardiography was additionally utilized in 3/13 (23{\%}). Ablation locations included: eight noncoronary (62{\%}), three left (23{\%}), and two right (15{\%}) cusps. Ablation was acutely successful in all patients. At median follow-up of 20 months, there was one recurrence of PVCs (8{\%}). There were no ablation-related complications and no valvular injuries observed. Conclusion: Arrhythmias originating from the coronary cusps in this series were successfully and safely ablated in young people without injury to the coronary arteries or the aortic valve.",
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T1 - A multicenter review of ablation in the aortic cusps in young people

AU - Nguyen, Minh B.

AU - Ceresnak, Scott R.

AU - Janson, Christopher M.

AU - Fishberger, Steven B.

AU - Love, Barry A.

AU - Blaufox, Andrew D.

AU - Motonaga, Kara S.

AU - Dubin, Anne M.

AU - Nappo, Lynn

AU - Pass, Robert H.

PY - 2017

Y1 - 2017

N2 - Background: Ablation within the aortic cusp is safe and effective in adults. There are little data on aortic cusp ablation in the pediatric literature. We investigated the safety and efficacy of aortic cusp ablation in young patients. Methods: A retrospective, descriptive study of aortic cusp ablation in five pediatric electrophysiology centers from 2008 to 2014 was performed. All patients <21 years of age who underwent ablation in the aortic cusps were included. Factors analyzed included patient demographics, procedural details, outcomes, and complications. Results: Thirteen patients met inclusion criteria (median age 16 years [range 10-20.5] and median body surface area 1.58 m2 [range 1.12-2.33]). Substrates for ablation included: nine premature ventricular contractions or sustained ventricular tachycardia (69%), two concealed anteroseptal accessory pathways (APs) (15%), one Wolff-Parkinson-White with an anteroseptal AP (8%), and one ectopic atrial tachycardia (8%). Three-dimensional electroanatomic mapping in combination with fluoroscopy was used in 12/13 (92%) patients. Standard 4-mm-tip radiofrequency (RF) current was used in 11/13 (85%) and low-power irrigated-tip RF in 2/13 (15%). Angiography was used in 13/13 and intracardiac echocardiography was additionally utilized in 3/13 (23%). Ablation locations included: eight noncoronary (62%), three left (23%), and two right (15%) cusps. Ablation was acutely successful in all patients. At median follow-up of 20 months, there was one recurrence of PVCs (8%). There were no ablation-related complications and no valvular injuries observed. Conclusion: Arrhythmias originating from the coronary cusps in this series were successfully and safely ablated in young people without injury to the coronary arteries or the aortic valve.

AB - Background: Ablation within the aortic cusp is safe and effective in adults. There are little data on aortic cusp ablation in the pediatric literature. We investigated the safety and efficacy of aortic cusp ablation in young patients. Methods: A retrospective, descriptive study of aortic cusp ablation in five pediatric electrophysiology centers from 2008 to 2014 was performed. All patients <21 years of age who underwent ablation in the aortic cusps were included. Factors analyzed included patient demographics, procedural details, outcomes, and complications. Results: Thirteen patients met inclusion criteria (median age 16 years [range 10-20.5] and median body surface area 1.58 m2 [range 1.12-2.33]). Substrates for ablation included: nine premature ventricular contractions or sustained ventricular tachycardia (69%), two concealed anteroseptal accessory pathways (APs) (15%), one Wolff-Parkinson-White with an anteroseptal AP (8%), and one ectopic atrial tachycardia (8%). Three-dimensional electroanatomic mapping in combination with fluoroscopy was used in 12/13 (92%) patients. Standard 4-mm-tip radiofrequency (RF) current was used in 11/13 (85%) and low-power irrigated-tip RF in 2/13 (15%). Angiography was used in 13/13 and intracardiac echocardiography was additionally utilized in 3/13 (23%). Ablation locations included: eight noncoronary (62%), three left (23%), and two right (15%) cusps. Ablation was acutely successful in all patients. At median follow-up of 20 months, there was one recurrence of PVCs (8%). There were no ablation-related complications and no valvular injuries observed. Conclusion: Arrhythmias originating from the coronary cusps in this series were successfully and safely ablated in young people without injury to the coronary arteries or the aortic valve.

KW - Ablation

KW - Angiography

KW - Aortic cusp

KW - Pediatrics

KW - SVT

KW - VT

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