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Catheter ablation in ASymptomatic PEDiatric patients with ventricular preexcitation: results from the multicenter “CASPED” study

  • Marta Telishevska
  • J. Hebe
  • T. Paul
  • J. H. Nürnberg
  • U. Krause
  • R. Gebauer
  • M. Gass
  • C. Balmer
  • F. Berger
  • S. Molatta
  • M. Emmel
  • W. Lawrenz
  • T. Kriebel
  • G. Hessling
Original Paper

Abstract

Background

As there are limited data about the clinical practice of catheter ablation in asymptomatic children and adolescents with ventricular preexcitation on ECG, we performed the multicenter “CASPED” (Catheter ablation in ASymptomatic PEDiatric patients with Ventricular Preexcitation) study.

Methods and results

In 182 consecutive children and adolescents aged between 8 and 18 years (mean age 12.9 ± 2.6 years; 65% male) with asymptomatic ventricular preexcitation, a total of 196 accessory pathways (APs) were targeted. APs were right sided (62%) or left sided (38%). The most common right-sided AP location was the posteroseptal region (38%). Ablation was performed using radiofrequency (RF) energy (93%), cryoablation (4%) or both (3%). Mean procedure time was 137.6 ± 62.0 min with a mean fluoroscopy time of 15.6 ± 13.8 min. A 3D mapping or catheter localization system was used in 32% of patients. Catheter ablation was acutely successful in 166/182 patients (91.2%). Mortality was 0% and there were no major periprocedural complications. AP recurrence was observed in 14/166 patients (8.4%) during a mean follow-up time of 19.7 ± 8.5 months. A second ablation attempt was performed in 20 patients and was successful in 16/20 patients (80%). Overall, long-term success rate was 92.3%.

Conclusion

In this retrospective multicenter study, the outcome of catheter ablation for asymptomatic preexcitation in children and adolescents irrespective of antegrade AP conduction properties is summarized. The complication rate was low and success rate was high, the latter mainly depending on pathway location. The promising results of the study may have future impact on the ongoing risk–benefit discussion regarding catheter ablation in the setting of asymptomatic preexcitation in children and adolescents.

Keywords

Accessory pathways Ventricular preexcitation Catheter ablation 

Notes

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Marta Telishevska
    • 1
  • J. Hebe
    • 2
  • T. Paul
    • 3
  • J. H. Nürnberg
    • 2
  • U. Krause
    • 3
  • R. Gebauer
    • 4
  • M. Gass
    • 5
  • C. Balmer
    • 6
  • F. Berger
    • 6
  • S. Molatta
    • 7
  • M. Emmel
    • 8
  • W. Lawrenz
    • 9
  • T. Kriebel
    • 10
  • G. Hessling
    • 1
  1. 1.Department of ElectrophysiologyGerman Heart Center MunichMunichGermany
  2. 2.Center f. Electrophysiology BremenBremenGermany
  3. 3.Pediatric Cardiology and Intensive Care MedicineGeorg August University GoettingenGoettingenGermany
  4. 4.Pediatric Cardiology, Heart CenterUniversity of LeipzigLeipzigGermany
  5. 5.ElectrophysiologyLake Constance Heart CenterConstanceGermany
  6. 6.Pediatric CardiologyUniversity Children’s Hospital ZurichZurichSwitzerland
  7. 7.Clinic for CardiologyHerz-und Diabeteszentrum NRW, Ruhr-University BochumBad OeynhausenGermany
  8. 8.Pediatric Cardiology, Heart CenterUniversity Hospital of CologneCologneGermany
  9. 9.Clinic for Pediatric CardiologyHeart Center DuisburgDuisburgGermany
  10. 10.Pediatric CardiologyWestpfalz-KlinikumKaiserslauternGermany

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