“If at first you don’t succeed”: repeat ablations in young patients with supraventricular tachycardia

Ellis Rochelson, Bradley C. Clark, Christopher M. Janson, Scott R. Ceresnak, Lynn Nappo, Robert H. Pass

Research output: Contribution to journalArticle

Abstract

Purpose: Success rates for catheter ablation of supraventricular tachycardia (SVT) in the young exceed 90%. While studies have described reasons for initial ablation failure, less is known about outcomes of repeat ablation attempts. The purpose of this study was to report acute and mid-term success rates for second ablation attempts in young patients, as well as to analyze factors that may affect these outcomes. Methods: Retrospective single-center study of all patients undergoing a second ablation attempt for WPW (Wolff-Parkinson-White) or SVT from 2008 to 2017. Inclusion criteria are all patients < 21 years old at the time of their first ablation who underwent a second ablation attempt. An intention to treat analysis was performed. Results: Fifty-five patients met inclusion criteria, with a median age of 15 years (IQR 12–16). The most common arrhythmia mechanisms at repeat procedure were single accessory pathways (n = 32, 58%) and AVNRT (n = 14, 25%). Six patients (11%) were found to have a different SVT mechanism than at initial ablation. Acute success at repeat ablation was achieved in 48 patients (87%). At mid-term follow-up (10.5 months, IQR 0.6–25), four patients (8% of acute successes) experienced SVT recurrence. The overall success rate of repeat ablations, accounting for acute and mid-term failures, was 80%. Conclusions: In this report of 55 young patients who underwent repeat ablation for WPW and/or SVT, acute and mid-term success rates were 87% and 80%, respectively. These data may help inform decision-making when caring for patients with persistent or recurrent SVT after an initial ablation attempt.

Original languageEnglish (US)
JournalJournal of Interventional Cardiac Electrophysiology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Supraventricular Tachycardia
Intention to Treat Analysis
Catheter Ablation
Statistical Factor Analysis
Cardiac Arrhythmias
Decision Making
Recurrence

Keywords

  • Catheter ablation
  • Pediatrics
  • Supraventricular tachycardia
  • Wolff-Parkinson-White syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

“If at first you don’t succeed” : repeat ablations in young patients with supraventricular tachycardia. / Rochelson, Ellis; Clark, Bradley C.; Janson, Christopher M.; Ceresnak, Scott R.; Nappo, Lynn; Pass, Robert H.

In: Journal of Interventional Cardiac Electrophysiology, 01.01.2019.

Research output: Contribution to journalArticle

@article{9aa1fba150ab4b3eb36e6e8465da5517,
title = "“If at first you don’t succeed”: repeat ablations in young patients with supraventricular tachycardia",
abstract = "Purpose: Success rates for catheter ablation of supraventricular tachycardia (SVT) in the young exceed 90{\%}. While studies have described reasons for initial ablation failure, less is known about outcomes of repeat ablation attempts. The purpose of this study was to report acute and mid-term success rates for second ablation attempts in young patients, as well as to analyze factors that may affect these outcomes. Methods: Retrospective single-center study of all patients undergoing a second ablation attempt for WPW (Wolff-Parkinson-White) or SVT from 2008 to 2017. Inclusion criteria are all patients < 21 years old at the time of their first ablation who underwent a second ablation attempt. An intention to treat analysis was performed. Results: Fifty-five patients met inclusion criteria, with a median age of 15 years (IQR 12–16). The most common arrhythmia mechanisms at repeat procedure were single accessory pathways (n = 32, 58{\%}) and AVNRT (n = 14, 25{\%}). Six patients (11{\%}) were found to have a different SVT mechanism than at initial ablation. Acute success at repeat ablation was achieved in 48 patients (87{\%}). At mid-term follow-up (10.5 months, IQR 0.6–25), four patients (8{\%} of acute successes) experienced SVT recurrence. The overall success rate of repeat ablations, accounting for acute and mid-term failures, was 80{\%}. Conclusions: In this report of 55 young patients who underwent repeat ablation for WPW and/or SVT, acute and mid-term success rates were 87{\%} and 80{\%}, respectively. These data may help inform decision-making when caring for patients with persistent or recurrent SVT after an initial ablation attempt.",
keywords = "Catheter ablation, Pediatrics, Supraventricular tachycardia, Wolff-Parkinson-White syndrome",
author = "Ellis Rochelson and Clark, {Bradley C.} and Janson, {Christopher M.} and Ceresnak, {Scott R.} and Lynn Nappo and Pass, {Robert H.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s10840-019-00672-2",
language = "English (US)",
journal = "Journal of Interventional Cardiac Electrophysiology",
issn = "1383-875X",
publisher = "Springer Netherlands",

}

TY - JOUR

T1 - “If at first you don’t succeed”

T2 - repeat ablations in young patients with supraventricular tachycardia

AU - Rochelson, Ellis

AU - Clark, Bradley C.

AU - Janson, Christopher M.

AU - Ceresnak, Scott R.

AU - Nappo, Lynn

AU - Pass, Robert H.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: Success rates for catheter ablation of supraventricular tachycardia (SVT) in the young exceed 90%. While studies have described reasons for initial ablation failure, less is known about outcomes of repeat ablation attempts. The purpose of this study was to report acute and mid-term success rates for second ablation attempts in young patients, as well as to analyze factors that may affect these outcomes. Methods: Retrospective single-center study of all patients undergoing a second ablation attempt for WPW (Wolff-Parkinson-White) or SVT from 2008 to 2017. Inclusion criteria are all patients < 21 years old at the time of their first ablation who underwent a second ablation attempt. An intention to treat analysis was performed. Results: Fifty-five patients met inclusion criteria, with a median age of 15 years (IQR 12–16). The most common arrhythmia mechanisms at repeat procedure were single accessory pathways (n = 32, 58%) and AVNRT (n = 14, 25%). Six patients (11%) were found to have a different SVT mechanism than at initial ablation. Acute success at repeat ablation was achieved in 48 patients (87%). At mid-term follow-up (10.5 months, IQR 0.6–25), four patients (8% of acute successes) experienced SVT recurrence. The overall success rate of repeat ablations, accounting for acute and mid-term failures, was 80%. Conclusions: In this report of 55 young patients who underwent repeat ablation for WPW and/or SVT, acute and mid-term success rates were 87% and 80%, respectively. These data may help inform decision-making when caring for patients with persistent or recurrent SVT after an initial ablation attempt.

AB - Purpose: Success rates for catheter ablation of supraventricular tachycardia (SVT) in the young exceed 90%. While studies have described reasons for initial ablation failure, less is known about outcomes of repeat ablation attempts. The purpose of this study was to report acute and mid-term success rates for second ablation attempts in young patients, as well as to analyze factors that may affect these outcomes. Methods: Retrospective single-center study of all patients undergoing a second ablation attempt for WPW (Wolff-Parkinson-White) or SVT from 2008 to 2017. Inclusion criteria are all patients < 21 years old at the time of their first ablation who underwent a second ablation attempt. An intention to treat analysis was performed. Results: Fifty-five patients met inclusion criteria, with a median age of 15 years (IQR 12–16). The most common arrhythmia mechanisms at repeat procedure were single accessory pathways (n = 32, 58%) and AVNRT (n = 14, 25%). Six patients (11%) were found to have a different SVT mechanism than at initial ablation. Acute success at repeat ablation was achieved in 48 patients (87%). At mid-term follow-up (10.5 months, IQR 0.6–25), four patients (8% of acute successes) experienced SVT recurrence. The overall success rate of repeat ablations, accounting for acute and mid-term failures, was 80%. Conclusions: In this report of 55 young patients who underwent repeat ablation for WPW and/or SVT, acute and mid-term success rates were 87% and 80%, respectively. These data may help inform decision-making when caring for patients with persistent or recurrent SVT after an initial ablation attempt.

KW - Catheter ablation

KW - Pediatrics

KW - Supraventricular tachycardia

KW - Wolff-Parkinson-White syndrome

UR - http://www.scopus.com/inward/record.url?scp=85076311096&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85076311096&partnerID=8YFLogxK

U2 - 10.1007/s10840-019-00672-2

DO - 10.1007/s10840-019-00672-2

M3 - Article

AN - SCOPUS:85076311096

JO - Journal of Interventional Cardiac Electrophysiology

JF - Journal of Interventional Cardiac Electrophysiology

SN - 1383-875X

ER -