Success rates in pediatric WPW ablation are improved with 3-dimensional mapping systems compared with fluoroscopy alone

A multicenter study

Scott R. Ceresnak, Anne M. Dubin, Jeffrey J. Kim, Santiago O. Valdes, Steven B. Fishberger, Ira Shetty, Frank Zimmerman, Ronn E. Tanel, Michael R. Epstein, Kara S. Motonaga, Christine A. Capone, Lynn Nappo, Gregory J. Gates, Robert H. Pass

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Introduction Three-dimensional mapping (3-D) systems are frequently used for ablation of supraventricular tachycardia. Prior studies have demonstrated radiation dosage reduction with 3-D, but there are no data on whether 3-D improves the efficacy of ablation of Wolff-Parkinson-White syndrome (WPW). We sought to determine if 3-D improves the success rate for ablation of WPW in children. Methods Multicenter retrospective study including patients ≤21 years of age with WPW undergoing ablation from 2008 to 2012. Success rates using the 2 techniques (3-D vs. fluoroscopy alone [FLUORO]) were compared. Results Six hundred and fifty-one cases were included (58% male, mean age 13 ± 4 years, 366 [56%] 3-D). Baseline characteristics including gender, weight, accessory pathway (AP) location, number of APs, and repeat ablation attempts were similar between the 2 groups (3-D and FLUORO) The 3-D group was slightly younger (12.7 ± 4.0 vs. 13.3 ± 4.0 years; P = 0.04) and less likely to undergo ablation utilizing cryoenergy (38 [10%] vs. 56 [20%]; P < 0.01). The 3-D group had a higher acute success rate of ablation (355 [97%] vs. 260 [91%]; P < 0.01). No differences were seen in recurrence (16 [5%] vs. 26 [9%]; P = 0.09) or complication rates (1 [0.3%] vs. 1 [0.4%]; P = 0.86) between the groups. On multivariable analysis, 3-D was shown to significantly improve success at ablation with an odds ratio of 3.1 (95% CI 1.44-6.72; P < 0.01). Conclusions Use of 3-D significantly improved success rates for ablation of WPW in children. The increase in acute success associated with 3-D suggests it is an important adjunct for catheter ablation of WPW in children.

Original languageEnglish (US)
Pages (from-to)412-416
Number of pages5
JournalJournal of Cardiovascular Electrophysiology
Volume26
Issue number4
DOIs
StatePublished - Apr 1 2015

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Wolff-Parkinson-White Syndrome
Fluoroscopy
Multicenter Studies
Pediatrics
Radiation Dosage
Supraventricular Tachycardia
Catheter Ablation
Retrospective Studies
Odds Ratio
Weights and Measures
Recurrence

Keywords

  • 3-D mapping
  • ablation
  • children
  • pediatrics
  • WPW

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Success rates in pediatric WPW ablation are improved with 3-dimensional mapping systems compared with fluoroscopy alone : A multicenter study. / Ceresnak, Scott R.; Dubin, Anne M.; Kim, Jeffrey J.; Valdes, Santiago O.; Fishberger, Steven B.; Shetty, Ira; Zimmerman, Frank; Tanel, Ronn E.; Epstein, Michael R.; Motonaga, Kara S.; Capone, Christine A.; Nappo, Lynn; Gates, Gregory J.; Pass, Robert H.

In: Journal of Cardiovascular Electrophysiology, Vol. 26, No. 4, 01.04.2015, p. 412-416.

Research output: Contribution to journalArticle

Ceresnak, SR, Dubin, AM, Kim, JJ, Valdes, SO, Fishberger, SB, Shetty, I, Zimmerman, F, Tanel, RE, Epstein, MR, Motonaga, KS, Capone, CA, Nappo, L, Gates, GJ & Pass, RH 2015, 'Success rates in pediatric WPW ablation are improved with 3-dimensional mapping systems compared with fluoroscopy alone: A multicenter study', Journal of Cardiovascular Electrophysiology, vol. 26, no. 4, pp. 412-416. https://doi.org/10.1111/jce.12623
Ceresnak, Scott R. ; Dubin, Anne M. ; Kim, Jeffrey J. ; Valdes, Santiago O. ; Fishberger, Steven B. ; Shetty, Ira ; Zimmerman, Frank ; Tanel, Ronn E. ; Epstein, Michael R. ; Motonaga, Kara S. ; Capone, Christine A. ; Nappo, Lynn ; Gates, Gregory J. ; Pass, Robert H. / Success rates in pediatric WPW ablation are improved with 3-dimensional mapping systems compared with fluoroscopy alone : A multicenter study. In: Journal of Cardiovascular Electrophysiology. 2015 ; Vol. 26, No. 4. pp. 412-416.
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abstract = "Introduction Three-dimensional mapping (3-D) systems are frequently used for ablation of supraventricular tachycardia. Prior studies have demonstrated radiation dosage reduction with 3-D, but there are no data on whether 3-D improves the efficacy of ablation of Wolff-Parkinson-White syndrome (WPW). We sought to determine if 3-D improves the success rate for ablation of WPW in children. Methods Multicenter retrospective study including patients ≤21 years of age with WPW undergoing ablation from 2008 to 2012. Success rates using the 2 techniques (3-D vs. fluoroscopy alone [FLUORO]) were compared. Results Six hundred and fifty-one cases were included (58{\%} male, mean age 13 ± 4 years, 366 [56{\%}] 3-D). Baseline characteristics including gender, weight, accessory pathway (AP) location, number of APs, and repeat ablation attempts were similar between the 2 groups (3-D and FLUORO) The 3-D group was slightly younger (12.7 ± 4.0 vs. 13.3 ± 4.0 years; P = 0.04) and less likely to undergo ablation utilizing cryoenergy (38 [10{\%}] vs. 56 [20{\%}]; P < 0.01). The 3-D group had a higher acute success rate of ablation (355 [97{\%}] vs. 260 [91{\%}]; P < 0.01). No differences were seen in recurrence (16 [5{\%}] vs. 26 [9{\%}]; P = 0.09) or complication rates (1 [0.3{\%}] vs. 1 [0.4{\%}]; P = 0.86) between the groups. On multivariable analysis, 3-D was shown to significantly improve success at ablation with an odds ratio of 3.1 (95{\%} CI 1.44-6.72; P < 0.01). Conclusions Use of 3-D significantly improved success rates for ablation of WPW in children. The increase in acute success associated with 3-D suggests it is an important adjunct for catheter ablation of WPW in children.",
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AU - Kim, Jeffrey J.

AU - Valdes, Santiago O.

AU - Fishberger, Steven B.

AU - Shetty, Ira

AU - Zimmerman, Frank

AU - Tanel, Ronn E.

AU - Epstein, Michael R.

AU - Motonaga, Kara S.

AU - Capone, Christine A.

AU - Nappo, Lynn

AU - Gates, Gregory J.

AU - Pass, Robert H.

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N2 - Introduction Three-dimensional mapping (3-D) systems are frequently used for ablation of supraventricular tachycardia. Prior studies have demonstrated radiation dosage reduction with 3-D, but there are no data on whether 3-D improves the efficacy of ablation of Wolff-Parkinson-White syndrome (WPW). We sought to determine if 3-D improves the success rate for ablation of WPW in children. Methods Multicenter retrospective study including patients ≤21 years of age with WPW undergoing ablation from 2008 to 2012. Success rates using the 2 techniques (3-D vs. fluoroscopy alone [FLUORO]) were compared. Results Six hundred and fifty-one cases were included (58% male, mean age 13 ± 4 years, 366 [56%] 3-D). Baseline characteristics including gender, weight, accessory pathway (AP) location, number of APs, and repeat ablation attempts were similar between the 2 groups (3-D and FLUORO) The 3-D group was slightly younger (12.7 ± 4.0 vs. 13.3 ± 4.0 years; P = 0.04) and less likely to undergo ablation utilizing cryoenergy (38 [10%] vs. 56 [20%]; P < 0.01). The 3-D group had a higher acute success rate of ablation (355 [97%] vs. 260 [91%]; P < 0.01). No differences were seen in recurrence (16 [5%] vs. 26 [9%]; P = 0.09) or complication rates (1 [0.3%] vs. 1 [0.4%]; P = 0.86) between the groups. On multivariable analysis, 3-D was shown to significantly improve success at ablation with an odds ratio of 3.1 (95% CI 1.44-6.72; P < 0.01). Conclusions Use of 3-D significantly improved success rates for ablation of WPW in children. The increase in acute success associated with 3-D suggests it is an important adjunct for catheter ablation of WPW in children.

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