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What have we learned in the last 20 years? A Comparison of a Modern Era Pediatric and Congenital Catheter Ablation Registry to Prior Pediatric Ablation Registries

Dubin, A. M.; Jorgensen, N. W.; Radbill, A. E.; Bradley, D. J.; Silva, J. N.; Tsao, S.; Kanter, R. J.; Tanel, R. E.; Trivedi, B.; Young, M. L.; Pflaumer, A.; McCormack, J.; Seslar, S. P.

Heart Rhythm. 2018 Aug 18

Abstract

BACKGROUND: Since the onset of pediatric catheter ablation, the pediatric electrophysiology community has reported outcomes via various registries (PAPCA and the Pediatric Catheter Ablation registry (PCAR)). Most recently, a modern era pediatric and congenital ablation registry (MAP-IT) was developed for eventual incorporation into the NCDR IMPACT registry. OBJECTIVE: We aimed to describe initial findings from the MAP-IT pilot registry, and compare these findings to earlier registries. METHODS: Prior to entering the NCDR IMPACT registry, MAP-IT was active at 12 centers (11 US) between October 2014 and April 2016. All EP studies were included for patients <21 years old and for patients of all ages with structural congenital heart disease (CHD). We compared the acute success, fluoroscopy and procedure times, and the frequency of complications between MAP-IT and the earlier registries. RESULTS: Acute success rates have improved from the initial PCAR registry for both accessory and slow pathway substrates. Both fluoroscopy and procedural time have significantly decreased across the time periods (fluoroscopy 47.6 +/- 40 minutes down to 7.0 +/- 9.2 minutes, p < 0.001; procedural time 257 +/- 157 minutes to 166 +/- 84 minutes, p <0.001). CONCLUSION: Acute success rates, fluoroscopy times and procedural times have all improved over the last 25 years in pediatric ablation.

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