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NASPE Expert Consensus Conference: Radiofrequency Catheter Ablation in Children with and without Congenital Heart Disease. Report of the Writing Committee
Author(s) -
FRIEDMAN RICHARD A.,
WALSH EDWARD P.,
SILKA MICHAEL J.,
CALKINS HUGH,
STEVENSON WILLIAM G.,
RHODES LARRY A.,
DEAL BARBARA J.,
WOLFF GRACE S.,
DEMASO DAVID R.,
HANISCH DEBRA,
VAN HARE GEORGE F.
Publication year - 2002
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2002.01000.x
Subject(s) - miami , medicine , medical school , general hospital , university hospital , st louis , family medicine , gerontology , pediatrics , medical education , history , art history , environmental science , soil science
A Consensus Conference on Pediatric Radiofrequency Catheter Ablation took place at the 21 Annual Scientific Sessions of the North American Society of Pacing and Electrophysiology (NASPE). The participants included health professionals from the pediatric and adult electrophysiological communities, and involved physicians, nurses, and other allied professionals. This statement attempts to coalesce the information presented and is directed to all health professionals who are involved in the care of pediatric patients undergoing ablation. In an attempt to write such a document, the editors must try to represent what they believed was the general consensus of opinion amongst the participants. As generally understood in the medical world, “consensus” does not indicate complete harmony within a group but a substantial degree of agreement. It is hoped that the information presented falls within that definition and will serve as a foundation on which to build toward in the future. Even as this document was being prepared, new technologies were introduced that may expand the indications and possibly the type of personnel and training necessary to perform these procedures. It will be interesting to look back on this statement of the current state-of-the art over the next 5–10 years and see if some of the recommendations stand the test of time. As is true of many documents, only in retrospect can a judgement be made on the strength of what is stated in this statement. The goal of the Consensus Conference was to bring together pediatric and adult practitioners in electrophysiology for an all day discussion of catheter ablation in children and in patients with congenital heart disease (CHD). The organizers believed that, in choosing topics for discussion, the development of indications for catheter ablation should flow naturally from what is known concerning the natural history of the arrhythmias in question in the pediatric population and from the latest information available concerning outcomes from these procedures. Therefore, the initial part of this statement deals with the natural history issues of specific arrhythmias in children with and without CHD. Issues of radiation exposure and animal models of toxicity due to radiofrequency (RF) application are noted followed by outcomes and complications of RF ablation for various arrhythmias. Indications for ablation are then discussed. It is important to realize that these indications as presented are not necessarily “written in stone” and do not take the place of a “Policy Statement.” Rather, as mentioned above, this represents a general sense of agreement within the community of pediatric and adult electrophysiologists . The second half of the conference then dealt with the “nuts and bolts” of performing these proNASPE POSITION STATEMENT