Long-Term Patient Experience Following Acutely Successful Ablation of Supraventricular Tachycardia Substrate in Children
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ORIGINAL ARTICLE
Long‑Term Patient Experience Following Acutely Successful Ablation of Supraventricular Tachycardia Substrate in Children Michael A. Fremed1 · Eric S. Silver1 · Anna Joong2 · Martin Liberman1 · Leonardo Liberman1 Received: 8 January 2020 / Accepted: 16 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Definitive treatment of supraventricular tachycardia (SVT) substrate involves catheter ablation. While objective success rates have been well established, long-term subjective patient experiences have not been well described. We quantify a subjective cure rate and characterize long-term patient experience after acutely successful ablation. A cross-sectional survey of pediatric patients with accessory pathways or atrioventricular nodal reentrant tachycardia who underwent acutely successful ablation from 2008 to 2012 was performed. Data were obtained from medical records and patient surveys. Patients with congenital heart disease other than patent ductus arteriosus, patent foramen ovale, or coronary artery abnormalities were excluded. Statistical analyses included Student’s t-test and χ2 analysis for continuous and categorical variables, respectively. Surveys were sent to 153 patients of which 147 responded with median follow-up of 7.2 (IQR 6.1–8.5) years. Of the 147 responders, 124 (84%) patients reported cure with a male predominance. Symptoms were present in 130/147 (88%) patients pre-ablation and in 53/147 (36%) post-ablation. Among those with post-ablation symptoms, 50/53 (94%) reported symptomatic improvement. Recurrence occurred in 23/147 (16%) patients and was more prevalent following cryoablation. Ablation of SVT substrate can be curative with excellent long-term results and patient satisfaction. Long-term subjective cure rate is high and there is a substantial decrease in symptoms post-ablation. Many patients continue to have symptoms following ablation; however, the majority of these patients consider themselves cured and symptoms can be attributed to other etiologies. Recurrence is uncommon and occurs more frequently following cryoablation. Keywords Supraventricular tachycardia · Ablation · Cure · Recurrence · Children
Introduction Catheter ablation using radiofrequency (RF) or cryoablation (CA) energy is the definitive treatment for supraventricular tachycardia (SVT) in both adults and children [1]. The most common forms of supraventricular tachycardia in children are atrioventricular reentrant tachycardia via an accessory Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00246-020-02459-z) contains supplementary material, which is available to authorized users. * Michael A. Fremed [email protected] 1
Division of Pediatric Cardiology, Columbia University Medical Center, 3959 Broadway, North Building, 2nd Floor, New York, NY 10032, USA
Division of Pediatric Cardiology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago
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