Skip to main content
SpringerLink
Log in

Long-Term Patient Experience Following Acutely Successful Ablation of Supraventricular Tachycardia Substrate in Children

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

Definitive treatment of supraventricular tachycardia (SVT) substrate involves catheter ablation. While objective success rates have been well established, long-term subjective patient experiences have not been well described. We quantify a subjective cure rate and characterize long-term patient experience after acutely successful ablation. A cross-sectional survey of pediatric patients with accessory pathways or atrioventricular nodal reentrant tachycardia who underwent acutely successful ablation from 2008 to 2012 was performed. Data were obtained from medical records and patient surveys. Patients with congenital heart disease other than patent ductus arteriosus, patent foramen ovale, or coronary artery abnormalities were excluded. Statistical analyses included Student’s t-test and χ2 analysis for continuous and categorical variables, respectively. Surveys were sent to 153 patients of which 147 responded with median follow-up of 7.2 (IQR 6.1–8.5) years. Of the 147 responders, 124 (84%) patients reported cure with a male predominance. Symptoms were present in 130/147 (88%) patients pre-ablation and in 53/147 (36%) post-ablation. Among those with post-ablation symptoms, 50/53 (94%) reported symptomatic improvement. Recurrence occurred in 23/147 (16%) patients and was more prevalent following cryoablation. Ablation of SVT substrate can be curative with excellent long-term results and patient satisfaction. Long-term subjective cure rate is high and there is a substantial decrease in symptoms post-ablation. Many patients continue to have symptoms following ablation; however, the majority of these patients consider themselves cured and symptoms can be attributed to other etiologies. Recurrence is uncommon and occurs more frequently following cryoablation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Saul JP, Kanter RJ et al (2016) “PACES/HRS expert consensus statement on the use of catheter ablation in children and patients with congenital heart disease. Heart Rhythm 13(6):e251–e289. https://doi.org/10.1016/j.hrthm.2016.02.009

    Article  Google Scholar 

  2. Ko JK, Deal BJ, Strasburger JF, Benson DW (1992) Supraventricular tachycardia mechanisms and their age distribution in pediatric patients. Am J Cardiol 69(12):1028–1032. https://doi.org/10.1016/0002-9149(92)90858-v

    Article  CAS  PubMed  Google Scholar 

  3. Quattrocelli A, Lang J, Davis A, Pflaumer A (2018) Age makes a difference: symptoms in pediatric supraventricular tachycardia”. J Arrhythm 34(5):565–571. https://doi.org/10.1002/joa3.12103

    Article  PubMed  PubMed Central  Google Scholar 

  4. Van Hare GF, Carmelli D, Smith WM, Kugler J, Silk M, Friedman R, Atkins D, Sual JP, Schaffer M, Byrum C, Dunnigan A, Colan S, Serwer G, participating members of the pediatric electrophysiology society (2002) Prospective assessment after pediatric cardiac ablation: design and implementation of the multicenter study. Pacing Clin Electrophysiol 25(3):332–341

    Article  Google Scholar 

  5. Van Hare GF, Javitz H, Carmelli D, Saul JP, Tanel RE, Fischbach PS, Kanter RJ, Schaffer M, Dunnigan A, Colan S, Serwer G (2004) Prospective assessment after pediatric cardiac ablation: demographics, medical profiles, and initial outcomes. J Cardiovasc Electrophysiol 15(7):759–770

    Article  Google Scholar 

  6. Kugler JD, Danford DA, Houston K, Felix G (1997) Radiofrequency catheter ablation for paroxysmal supraventricular tachycardia in children and adolescents without structural heart disease. Pediatric EP Society, Radiofrequency Catheter Ablation Registry. Am J Cardiol 80(11):1438–1443

    Article  CAS  Google Scholar 

  7. Kugler JD, Danford DA, Houston K, Felix G (2002) Pediatric radiofrequency catheter ablation registry success, fluoroscopy time, and complication rate for supraventricular tachycardia: a comparison of early and recent eras. J Cardiovasc Electrophysiol 13(4):336–341

    Article  Google Scholar 

  8. Deisenhofer I, Zrenner B, Yin YH, Pitschner HF, Kuniss M, Grossmann G, Stiller S, Luik A, Veltmann C, Frank J, Linner J, Estner HL, Pflaumer A, Wu J, von Bary C, Ucer E, Reents T, Tzeis S, Fichtner S, Kathan S, Karch MR, Jilek C, Ammar S, Kolb C, Liu ZC, Haller B, Schmitt C, Hessling G (2010) Cryoablation versus radiofrequency energy for the ablation of atrioventricular nodal reentrant tachycardia (the CYRANO study): results from a large multicenter prospective randomized trial”. Circulation 122(22):2239–2245. https://doi.org/10.1161/CIRCULATIONAHA.110.970350

    Article  PubMed  Google Scholar 

  9. Backhoff D, Klehs S, Müller MJ, Schneider HE, Dieks JK, Paul T, Krause U (2018) Long-term follow-up after radiofrequency catheter ablation of accessory atrioventricular pathways in children. JACC Clin Electrophysiol 4(4):448–455. https://doi.org/10.1016/j.jacep.2018.02.017

    Article  PubMed  Google Scholar 

  10. Backhoff D, Klehs S, Müller MJ, Schneider HE, Kriebel T, Paul T, Krause U (2016) Long-term follow-up after catheter ablation of atrioventricular nodal reentrant tachycardia in children. Circ Arrhythm Electrophysiol 9(11):e004264. https://doi.org/10.1161/CIRCEP.116.004264

    Article  PubMed  Google Scholar 

  11. Bhat DP, Du W, Karpawich PP (2014) Testing efficacy in determination of recurrent supraventricular tachycardia among subjectively symptomatic children following ‘successful’ ablation. Pacing Clin Electrophysiol 37(8):1009–1016. https://doi.org/10.1111/pace.12373

    Article  PubMed  Google Scholar 

  12. Buddhe S, Sing H, Du W, Karpawich PP (2012) Radiofrequency and cryoablation therapies for supraventricular arrhythmias in the young: five-year review of efficacies. Pacing Clin Electrophysiol 35(6):711–717. https://doi.org/10.1111/j.1540-8159.2012.03372.x

    Article  PubMed  Google Scholar 

  13. Das S, Law IH, Von Bergen NH, Bradley DJ, Dick M, Etheridge SP, Saarel EV, Frias PA, Strieper MJ, Fischbach PS (2012) Cryoablation therapy for atrioventricular nodal reentrant tachycardia in children: a multicenter experience of efficacy. Pediatr Cardiol 33(7):1147–1153. https://doi.org/10.1007/s00246-012-0273-0

    Article  PubMed  Google Scholar 

  14. LaPage MJ, Saul JP, Reed JH (2010) Long-term outcomes for cryoablation of pediatric patients with atrioventricular nodal reentrant tachycardia. Am J Cardiol 105(8):1118–1121. https://doi.org/10.1016/j.amjcard.2009.12.014

    Article  PubMed  Google Scholar 

  15. Papagianni J, Papadopoulou K, Rammos S, Katritsis D (2010) Cryoablation versus radiofrequency ablation for atrioventricular nodal reentrant tachycardia in children: long-term results. Hellenic J Cardiol 51(2):1

    Google Scholar 

  16. Kubus P, Vit P, Gebauer R, Zaoral L, Peichl P, Fiala M, Janousek J (2014) Long-term results of paediatric radiofrequency catheter ablation: a population based study. EP Europace 16(12):1808–1813

    Article  Google Scholar 

  17. Brachmann J, Lewalter T, Kuck KH, Andresen D, Willems S, Spitzer SG, Straube F, Schumacher B, Eckardt L, Danilovic D, Thomas D, Hochadel M, Senges J (2017) Long-term symptom improvement and patient satisfaction following catheter ablation of supraventricular tachycardia: insights from the German ablation registry. Eur Heart J 38(17):1317–1326. https://doi.org/10.1093/eurheartj/ehx101

    Article  PubMed  Google Scholar 

  18. Wood KA, Stewart AL, Drew BJ, Scheinman MM, Froëlicher ES (2010) Changes in patient perceptions and quality of life following ablation in patients with supraventricular tachycardia. Heart Lung 39(1):12. https://doi.org/10.1016/j.hrtlng.2009.04.001

    Article  PubMed  Google Scholar 

  19. Boerma T, Hosseinpoor AR, Verdes E, Chatterji S (2016) A global assessment of the gender gap in selp-reported health with survey data from 59 countries. BMC Public Health 16:675. https://doi.org/10.1186/s12889-016-3352-y

    Article  PubMed  PubMed Central  Google Scholar 

  20. Rodriguez-Entem FJ, Expósito V, Gonzalez-Enriquez S, Olalla-Antolin JJ (2013) Cryoablation versus radiofrequency ablation for the treatment of atrioventricular nodal reentrant tachycardia: results of a prospective randomized study. J Interv Cardiac Electrophysiol. 36(1):41–45. https://doi.org/10.1007/s10840-012-9732-z. discussion 45

    Article  Google Scholar 

  21. Santangeli P, Proietti R, Di Biase L, Bai R, Natale A (2014) Cryoablation versus radiofrequency ablation of atrioventricular nodal reentrant tachycardia. J Interv Cardiac Electrophysiol 39(2):111–119. https://doi.org/10.1007/s10840-013-9842-2

    Article  Google Scholar 

  22. Hanninen M, Yeung-Lai-Wah N, Massel D, Gula LJ, Skanes AC, Yee R, Klein GJ, Manlucu J, Leong-Sit P (2013) Cryoablation versus RF ablation for AVNRT: a meta-analysis and systematic review. J Cardiovasc Electrophysiol 24(12):1354–1360. https://doi.org/10.1111/jce.12247

    Article  PubMed  Google Scholar 

  23. Drago F, Russo MS, Silvetti MS, Santis AD, Iodice F, Naso Onofrio MT (2010) Cryoablation of typical atrioventricular nodal reentrant tachycardia in children: six years’ experience and follow-up in a single center. Pacing Clin Electrophysiol 33:475–481

    Article  Google Scholar 

  24. Peyrol M, Sbragia P, Uhry S, Boccara G, Dolla E, Quatre A, Guenoun M, Levy S, Paganelli F (2013) Slow pathway elimination for atrioventricular nodal reentrant tachycardia with the 8-mm tip cryoablation catheter: an18-monthfollow-up study. J Interv Card Electrophysiol 37:105–109

    Article  Google Scholar 

  25. Qureshi MY, Ratnasamy C, Sokoloski M, Young ML (2013) Low recurrence rate in treating atrioventricular nodal reentrant tachycardia with triple freeze-thaw cycles. Pacing Clin Electrophysiol 36:279–285

    Article  Google Scholar 

  26. Tuzcu V, Gul EE, Karacan M et al (2017) Comparison of 6-mm versus 8-mm-tip cryoablation catheter for the treatment of atrioventricular nodal reentrant tachycardia in children: a prospective study. Pediatr Cardiol 38:1220–1225. https://doi.org/10.1007/s00246-017-1648-z

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Funding is provided by Colin’s Kids, Inc.

Author information

Authors and Affiliations

  1. Division of Pediatric Cardiology, Columbia University Medical Center, 3959 Broadway, North Building, 2nd Floor, New York, NY, 10032, USA

    Michael A. Fremed, Eric S. Silver, Martin Liberman & Leonardo Liberman

  2. Division of Pediatric Cardiology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA

    Anna Joong

Authors
  1. Michael A. Fremed
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eric S. Silver
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anna Joong
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martin Liberman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Leonardo Liberman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael A. Fremed.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

The appropriate informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 133 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fremed, M.A., Silver, E.S., Joong, A. et al. Long-Term Patient Experience Following Acutely Successful Ablation of Supraventricular Tachycardia Substrate in Children. Pediatr Cardiol 42, 109–115 (2021). https://doi.org/10.1007/s00246-020-02459-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-020-02459-z

Keywords

Search

Navigation