The Pediatric Radiofrequency Ablation Registry's Experience with Ebstein's Anomaly
Identifieur interne : 001E57 ( Main/Exploration ); précédent : 001E56; suivant : 001E58The Pediatric Radiofrequency Ablation Registry's Experience with Ebstein's Anomaly
Auteurs : Jonathan D. Reich [Géorgie (pays)] ; Debbie Auld [Géorgie (pays)] ; Edward Hulse [Géorgie (pays)] ; Kevin Sullivan [Géorgie (pays)] ; Robert Campbell [Géorgie (pays)]Source :
- Journal of Cardiovascular Electrophysiology [ 1045-3873 ] ; 1998-12.
English descriptors
Abstract
Radiofrequency Ablation in Pediatric Ebstein's Anomaly. Introduction: Abnormal anatomy and complex electrophysiology in patients with Ebstein's anomaly of the tricuspid valve may confound attempts at radiofrequency ablation (RFA). Methods and Results: Data for 65 pediatric Ebstein's patients (9.8 ± 5.4 years, 4 months to 20 years; 39 ± 25 kg, 5.1 to 108 kg) were obtained from the Pediatric Radiofrequency Ablation Registry. The degree of tricuspid regurgitation (DOTR) and the degree of Ebstein's anomaly were assessed with echocardiography/Doppler. Leading indications were drug refractoriness (24 [37%] of 65 patients) and life‐threatening arrhythmia (14 [22%] of 65 patients). For the 65 patients, 82 typical (nondecremental) accessory pathways (APs) (62% right free wall, 34% right septal, and 4% left sided), 17 other supraventricular tachycardias (1 ectopic atrial, 7 AV reentry, 5 Mahaim, and 4 intra‐atrial reentry tachycardias), and 1 ventricular mechanism were mapped. Thirty‐four (52%) of 65 patients had a single AP (21 right free wall, 10 septal, and 3 left); 19 (29%) of 65 patients multiple APs; 6 (9%) of 65 patients a single AP plus a non‐AP mechanism; and 6 (9%) of 65 patients non‐AP mechanism(s) only. REA acute success rates and recurrence rates for right free wall, right septal, and other mechanisms were 79%/32%, 89%/29%, and 75%/27%. Mild DOTR and a body surface area (BSA) ≤ 1.7 m2 independently predicted a better acute success rate. BSA ≤ 1.7 m2 also predicted long‐term success. Conclusion: In this patient subset, life‐threatening arrhythmias and multiple electrophysiologic mechanisms are commonly encountered during REA. Mild DOTR and a BSA ≥ 1.7 m2 predict a higher acute success rate. While acute success rates are relatively high, recurrence is frequent.
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DOI: 10.1111/j.1540-8167.1998.tb00113.x
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Reich</name></author><author><name sortKey="Auld, Debbie" sort="Auld, Debbie" uniqKey="Auld D" first="Debbie" last="Auld">Debbie Auld</name></author><author><name sortKey="Hulse, Edward" sort="Hulse, Edward" uniqKey="Hulse E" first="Edward" last="Hulse">Edward Hulse</name></author><author><name sortKey="Sullivan, Kevin" sort="Sullivan, Kevin" uniqKey="Sullivan K" first="Kevin" last="Sullivan">Kevin Sullivan</name></author><author><name sortKey="Campbell, Robert" sort="Campbell, Robert" uniqKey="Campbell R" first="Robert" last="Campbell">Robert Campbell</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:C4BA594D566346A9C0D417517AAAC1EC0BC12339</idno><date when="1998" year="1998">1998</date><idno type="doi">10.1111/j.1540-8167.1998.tb00113.x</idno><idno type="url">https://api.istex.fr/document/C4BA594D566346A9C0D417517AAAC1EC0BC12339/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">002C71</idno><idno type="wicri:Area/Main/Curation">002899</idno><idno type="wicri:Area/Main/Exploration">001E57</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">The Pediatric Radiofrequency Ablation Registry's Experience with Ebstein's Anomaly</title><author><name sortKey="Reich, Jonathan D" sort="Reich, Jonathan D" uniqKey="Reich J" first="Jonathan D." last="Reich">Jonathan D. Reich</name><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>The Children's Heart Center, Rollins School of Public Health, Emory University School of Medicine, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Auld, Debbie" sort="Auld, Debbie" uniqKey="Auld D" first="Debbie" last="Auld">Debbie Auld</name><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>The Children's Heart Center, Rollins School of Public Health, Emory University School of Medicine, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Hulse, Edward" sort="Hulse, Edward" uniqKey="Hulse E" first="Edward" last="Hulse">Edward Hulse</name><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>The Children's Heart Center, Rollins School of Public Health, Emory University School of Medicine, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Sullivan, Kevin" sort="Sullivan, Kevin" uniqKey="Sullivan K" first="Kevin" last="Sullivan">Kevin Sullivan</name><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>Department of Pediatrics, Department of Epidemiology, Rollins School of Public Health, Emory University School of Medicine, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author><author><name sortKey="Campbell, Robert" sort="Campbell, Robert" uniqKey="Campbell R" first="Robert" last="Campbell">Robert Campbell</name><affiliation wicri:level="1"><country xml:lang="fr">Géorgie (pays)</country><wicri:regionArea>The Children's Heart Center, Rollins School of Public Health, Emory University School of Medicine, Atlanta</wicri:regionArea><wicri:noRegion>Atlanta</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Cardiovascular Electrophysiology</title><idno type="ISSN">1045-3873</idno><idno type="eISSN">1540-8167</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1998-12">1998-12</date><biblScope unit="volume">9</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1370">1370</biblScope><biblScope unit="page" to="1377">1377</biblScope></imprint><idno type="ISSN">1045-3873</idno></series><idno type="istex">C4BA594D566346A9C0D417517AAAC1EC0BC12339</idno><idno type="DOI">10.1111/j.1540-8167.1998.tb00113.x</idno><idno type="ArticleID">JCE1370</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1045-3873</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Ebstein's anomaly</term><term>arrhythmia</term><term>catheter ablation</term><term>pediatrics</term><term>tricuspid valve</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Radiofrequency Ablation in Pediatric Ebstein's Anomaly. Introduction: Abnormal anatomy and complex electrophysiology in patients with Ebstein's anomaly of the tricuspid valve may confound attempts at radiofrequency ablation (RFA). Methods and Results: Data for 65 pediatric Ebstein's patients (9.8 ± 5.4 years, 4 months to 20 years; 39 ± 25 kg, 5.1 to 108 kg) were obtained from the Pediatric Radiofrequency Ablation Registry. The degree of tricuspid regurgitation (DOTR) and the degree of Ebstein's anomaly were assessed with echocardiography/Doppler. Leading indications were drug refractoriness (24 [37%] of 65 patients) and life‐threatening arrhythmia (14 [22%] of 65 patients). For the 65 patients, 82 typical (nondecremental) accessory pathways (APs) (62% right free wall, 34% right septal, and 4% left sided), 17 other supraventricular tachycardias (1 ectopic atrial, 7 AV reentry, 5 Mahaim, and 4 intra‐atrial reentry tachycardias), and 1 ventricular mechanism were mapped. Thirty‐four (52%) of 65 patients had a single AP (21 right free wall, 10 septal, and 3 left); 19 (29%) of 65 patients multiple APs; 6 (9%) of 65 patients a single AP plus a non‐AP mechanism; and 6 (9%) of 65 patients non‐AP mechanism(s) only. REA acute success rates and recurrence rates for right free wall, right septal, and other mechanisms were 79%/32%, 89%/29%, and 75%/27%. Mild DOTR and a body surface area (BSA) ≤ 1.7 m2 independently predicted a better acute success rate. BSA ≤ 1.7 m2 also predicted long‐term success. Conclusion: In this patient subset, life‐threatening arrhythmias and multiple electrophysiologic mechanisms are commonly encountered during REA. Mild DOTR and a BSA ≥ 1.7 m2 predict a higher acute success rate. While acute success rates are relatively high, recurrence is frequent.</div></front></TEI><affiliations><list><country><li>Géorgie (pays)</li></country></list><tree><country name="Géorgie (pays)"><noRegion><name sortKey="Reich, Jonathan D" sort="Reich, Jonathan D" uniqKey="Reich J" first="Jonathan D." last="Reich">Jonathan D. Reich</name></noRegion><name sortKey="Auld, Debbie" sort="Auld, Debbie" uniqKey="Auld D" first="Debbie" last="Auld">Debbie Auld</name><name sortKey="Campbell, Robert" sort="Campbell, Robert" uniqKey="Campbell R" first="Robert" last="Campbell">Robert Campbell</name><name sortKey="Hulse, Edward" sort="Hulse, Edward" uniqKey="Hulse E" first="Edward" last="Hulse">Edward Hulse</name><name sortKey="Sullivan, Kevin" sort="Sullivan, Kevin" uniqKey="Sullivan K" first="Kevin" last="Sullivan">Kevin Sullivan</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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