TY - JOUR
T1 - Utility of Echocardiography in Detecting Silent Complications After Pediatric Catheter Ablations
AU - Amdani, Shahnawaz M.
AU - Sallaam, Salaam
AU - Karpawich, Peter P.
AU - Aggarwal, Sanjeev
N1 - Publisher Copyright:
© 2017, Springer Science+Business Media, LLC.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Although transcatheter arrhythmia ablation (TCA) has been performed in children for over two decades, guidelines for routine use of post-ablation transthoracic echocardiography (TTE) are absent. We sought to determine the efficacy of TTE after apparently uneventful TCA procedures in detecting adverse findings and identify predisposing factors. A retrospective review of clinical and procedural data on patients who underwent TCA for supraventricular arrhythmias from 2000 to 2015 was performed. Pre- and post-ablation TTE data were reviewed. All patients were followed at 1 week, 6 and 12 months post-TCA. A repeat TTE was performed at 12 months on patients in whom post-TCA abnormalities were found. Patients were divided into two groups: those with and without adverse TTE findings and comparative analysis between variables was performed. Data on 252 patients, 52% males, mean age 14 ± 3 years were analyzed. New onset or worsening atrioventricular valve regurgitation occurred in 17 (6.7%), a small pericardial effusion in 3 (1.2%) and worsened ventricular function in 2 patients (0.8%). Patients in the complication group had higher mean number of ablations (22.6 ± 15.3 vs. 16.8 ± 9.2, p 0.001) and required longer duration of ablation (sec) (254.6 ± 256.4 vs. 180.9 ± 158.9, p < 0.001). TCA location (including coronary sinus), energy source, arrhythmia substrate, and a trans-septal approach were noncontributory to any adverse findings. Routine post-ablation TTE uncovers asymptomatic self-resolving abnormalities that typically do not require any intervention.
AB - Although transcatheter arrhythmia ablation (TCA) has been performed in children for over two decades, guidelines for routine use of post-ablation transthoracic echocardiography (TTE) are absent. We sought to determine the efficacy of TTE after apparently uneventful TCA procedures in detecting adverse findings and identify predisposing factors. A retrospective review of clinical and procedural data on patients who underwent TCA for supraventricular arrhythmias from 2000 to 2015 was performed. Pre- and post-ablation TTE data were reviewed. All patients were followed at 1 week, 6 and 12 months post-TCA. A repeat TTE was performed at 12 months on patients in whom post-TCA abnormalities were found. Patients were divided into two groups: those with and without adverse TTE findings and comparative analysis between variables was performed. Data on 252 patients, 52% males, mean age 14 ± 3 years were analyzed. New onset or worsening atrioventricular valve regurgitation occurred in 17 (6.7%), a small pericardial effusion in 3 (1.2%) and worsened ventricular function in 2 patients (0.8%). Patients in the complication group had higher mean number of ablations (22.6 ± 15.3 vs. 16.8 ± 9.2, p 0.001) and required longer duration of ablation (sec) (254.6 ± 256.4 vs. 180.9 ± 158.9, p < 0.001). TCA location (including coronary sinus), energy source, arrhythmia substrate, and a trans-septal approach were noncontributory to any adverse findings. Routine post-ablation TTE uncovers asymptomatic self-resolving abnormalities that typically do not require any intervention.
KW - Atrioventricular nodal reentrant tachycardia (AVNRT)
KW - Atrioventricular reentrant tachycardia (AVRT)
KW - Cryoablation
KW - Echocardiogram
KW - Pericardial effusion
KW - Radiofrequency ablation
KW - Supraventricular tachycardia (SVT)
KW - Valvular regurgitation
KW - Ventricular function
UR - http://www.scopus.com/inward/record.url?scp=85023742190&partnerID=8YFLogxK
U2 - 10.1007/s00246-017-1680-z
DO - 10.1007/s00246-017-1680-z
M3 - Article
C2 - 28711964
AN - SCOPUS:85023742190
VL - 38
SP - 1426
EP - 1433
JO - Pediatric Cardiology
JF - Pediatric Cardiology
SN - 0172-0643
IS - 7
ER -