“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 - 2019

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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