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Etiology is a predictor of recurrence after catheter ablation of ventricular arrhythmias in pediatric patients
Author(s) -
Gulletta Simone,
Vergara Pasquale,
Vitulano Gennaro,
Foppoli Luca,
D'Angelo Giuseppe,
Cireddu Manuela,
Bisceglia Caterina,
Paglino Gabriele,
Sala Simone,
Capogrosso Cristina,
Pan Luigi,
Falasconi Giulio,
Trevisi Nicola,
Agricola Eustachio,
Della Bella Paolo
Publication year - 2021
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14984
Subject(s) - medicine , interquartile range , catheter ablation , hazard ratio , ventricular tachycardia , cardiology , confidence interval , etiology , tachycardia , ablation
Background Ventricular arrhythmias (VAs) are rare in pediatric patients, especially in absence of structural heart disease (SHD). Few data are available regarding the invasive VAs treatment with catheter ablation (CA) in pediatric patients and predictors of outcomes have not been fully investigated. Objective To describe the clinical presentation, procedural characteristics, and outcomes in pediatric patients undergoing CA for VAs. Methods Eighty‐one consecutive pediatric patients (58 male [72%], 15.5 ± 2.2 years) treated by CA for ventricular tachycardia (VT) or premature ventricular beats (PVBs) were retrospectively evaluated. Study endpoints were VAs recurrence and mortality for any cause. Results Ninety‐five procedures were performed in 81 patients, 52 (55%) PVBs and 43 (45%) VT ablations. During a follow‐up of 35.0 months (interquartile range = 13.0–71.0), 14 patients (14.7%) had a VA recurrence: 11 (33.3%) patients treated with CA for VT and 3 (6.2%) patients treated for PVBs ( p < .001). One patient (1%) died 26 months after the procedure during an electrical storm. Patients with SHD had higher VAs recurrence rate, as compared with idiopathic VAs (pairwise log‐rank p < .001). Patients treated with CA for VT had higher VA recurrence rate, as compared with PVB patients (pairwise log‐rank p = .002). At Cox multivariate analysis only SHD was an independent predictor of VAs recurrence (hazard ratio = 5.56, 95% confidence interval = 2.68–11.54, p < .001). Conclusion CA of VAs is effective and safe in a pediatric population. CA of idiopathic and fascicular VAs are associated with lower recurrence rate, than VAs in the setting of SHD.