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Patient and Procedural Correlates of Fluoroscopy Use During Catheter Ablation in the Pediatric and Congenital Electrophysiology Lab.
MedLine Citation:
PMID:  25099613     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To identify factors associated with fluoroscopy use in pediatric and congenital heart disease (CHD) patients.
DESIGN: Retrospective cohort.
SETTING: Pediatric electrophysiology lab in a single tertiary-care children's hospital.
PATIENTS: Three hundred eighty-three patients who underwent electrophysiology study and ablation between January 2010 and December 2012.
METHODS: Ablation procedures in which nonfluoroscopic navigation was employed were reviewed. Procedures using ≥10 minutes of fluoroscopy (high-fluoroscopy time; HF) were compared with those using <10 minutes (low-fluoroscopy time; LF). Group comparison of characteristics was made in the entire cohort and in CHD and anatomically normal heart subsets.
RESULTS: During the study period, 416 ablation procedures were performed involving 471 substrates in 383 patients. Median fluoroscopy time was 6.7 minutes overall and 5.1 minutes with anatomically normal hearts. LF comprised 61% of all ablation and 69% of anatomically normal hearts. LF procedures were associated with anatomically normal hearts (93% vs. 63%; P < .0001). In anatomically normal hearts, HF was associated with accessory pathways (64% vs. 47%; P = .01), posteroseptal substrates (22% vs. 9%; P = .002), and ventricular substrates (12% vs. 1%; P < .0001). All cases of intra-atrial reentrant tachycardia were HF. HF was associated with trans-septal puncture (47% vs. 23%; P < .0001) though not when controlling for atrioventricular nodal reentrant tachycardia. LF was associated with cryoablation (56% vs. 17%; P < .0001).
CONCLUSIONS: In pediatric and congenital EP, ablation procedures using cryoablation and in patients with anatomically normal hearts are associated with LF. In accessory pathway ablation, HF was not associated with trans-septal puncture.
Authors:
Adam C Kean; Martin J Lapage; Sunkyung Yu; Macdonald Dick; David J Bradley
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-7
Journal Detail:
Title:  Congenital heart disease     Volume:  -     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2014 Wiley Periodicals, Inc.
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