Catheter ablation in ASymptomatic PEDiatric patients with ventricular preexcitation: results from the multicenter “CASPED” study

Telishevska, Marta; Hebe, Joachim; Paul, Thomas; Nürnberg, Jan‐Hendrik; Krause, Ulrich; Gebauer, Roman; Gass, Matthias; Balmer, Christian; Berger, F; Molatta, Stephan; Emmel, Mathias; Lawrenz, Wolfgang; Kriebel, Thomas; Hessling, Gabriele

doi:10.1007/s00392-018-1397-x

Cited by 17 publications

(8 citation statements)

References 15 publications

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“…In the present study, 105 procedures for AP ablation were included, 45 (42.9%) of which were performed utilizing 3D mapping, consistent to previously reported rates of 32%–56% 13,14 . Use of 3D mapping in ablation of APs is associated with lower fluoroscopy time and shorter procedure time 15 .…”

Section: Discussionsupporting

confidence: 72%

“…In the present study, 105 procedures for AP ablation were included, 45 (42.9%) of which were performed utilizing 3D mapping, consistent to previously reported rates of 32%-56%. 13,14 Use of 3D mapping in ablation of APs is associated with lower fluoroscopy time and shorter procedure time. 15 In line with these data, we report a significantly lower fluoroscopy time and DAP with use of 3D mapping without any impact on procedure time.…”

Section: Discussionmentioning

confidence: 99%

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Utilization of 3D mapping systems in interventional electrophysiology and its impact on procedure time and fluoroscopy—Insights from the “Go for Zero Fluoroscopy” project

Zormpas

Hillmann

Hohmann

et al. 2023

Pacing Clinical Electrophis

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AimThe implementation of 3D mapping systems plays an important role in interventional electrophysiology (EP) in recent years. The aim of the present study was to evaluate use of 3D mapping systems regarding fluoroscopy and procedure duration.MethodIn the “Go for Zero Fluoroscopy” project 25 European centers provided data of consecutive EP procedures. Data on use of 3D mapping systems as well as utilization of contact force catheters and multipolar mapping catheters were associated with fluoroscopy time, dose area product (DAP), and procedure duration.ResultA 3D mapping system was used in 966 (54%) cases. Use of 3D mapping for atrioventricular nodal reentry tachycardia (AVNRT) was associated with reduced fluoroscopy time (p < 0.001), DAP (p = 0.04) but increased procedure time (p = 0.029). Moreover, fluoroscopy time (p < 0.001) and DAP (p = 0.005) were significantly lower in the 3D mapping group in ablation of typical atrial flutter. However, the procedure time (p < 0.001) increased. Use of 3D mapping in the ablation of accessory pathway (AP) was associated with reduced fluoroscopy time (p < 0.001) and DAP (p < 0.001) with no significant increase in procedure time (p = 0.066). In the case of atrial fibrillation, a 3D mapping system was used in 485 patients (75.8%). Additional use of a contact force catheter was associated with lower fluoroscopy time (p < 0.001) and DAP (p < 0.001). Use of a multipolar mapping catheter was associated with lower fluoroscopy time (p = 0.002). The implementation of 3D mapping systems in the ablation of ventricular tachycardias resulted in a significant increase in the procedure time (p = 0.001) without significant differences regarding the DAP (p = 0.773) and fluoroscopy time (p = 0.249).ConclusionUse of 3D mapping systems in ablation of supraventricular tachycardias is associated with lower radiation exposure. Nevertheless, the procedure time often increases, except in the case of ablation for AP. Use of contact force catheters and multipolar mapping catheters is associated with yet lower radiation exposure values. Prospective randomized studies are needed to further elucidate potential benefit of these technological tools.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Utilization of 3D mapping systems in interventional electrophysiology and its impact on procedure time and fluoroscopy—Insights from the “Go for Zero Fluoroscopy” project

Zormpas

Hillmann

Hohmann

et al. 2023

Pacing Clinical Electrophis

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“…Because of the uncertainty that comes with risk stratification of asymptomatic patients with preexcitation using available methods, and the low complication rate of ablation in the modern era, there is currently a low threshold to offer EPS and ablation to those patients [ 36 , 37 ]. If we agree that physical activity, especially at a competitive level, imposes an increased risk of triggering a potentially life-threatening arrhythmia, then there is even more argument to take this approach in the management of young athletes.…”

Section: Discussionmentioning

confidence: 99%

Management of Young Athletes with Asymptomatic Preexcitation—A Review of the Literature

2020

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Introduction: The management of young athletes with asymptomatic preexcitation remains a challenge, regardless of the progress we have made in understanding the basis of condition and developing catheter ablation procedures. The risk of sudden death, however small, yet definite, being the first symptom is determining our approach. The aim of the study was to establish the current state of knowledge regarding the management of young athletes diagnosed with asymptomatic preexcitation, by conducting a literature review. Material and methods: A comprehensive literature review was completed in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was limited to English language publications using the following search terms: “asymptomatic” or “incidental” and “pre-excitation” or “Wolff–Parkinson–White” or “delta wave” and “athlete” or “sport”. The search was supplemented by hand review of the bibliographies of previous relevant systematic reviews. Results: The search resulted in 85 of abstracts, and the manual search of the bibliographies resulted in 24 additional papers. After careful analysis 10 publications were included in the review. In all but one of the presented papers, the authors used non-invasive methods and then either trans-esophageal or invasive EPS as a way to risk stratify asymptomatic patients. Evidence of rapid conduction through the accessory pathway was considered high risk and prompted sport disqualification. In the analysed reports there were combined: 142 episodes of the life-threatening events (LTE)/sudden death (SCD), of which 56 were reported to occur at rest, 61 during activity and no data were available for 25. Conclusions: athletic activity may impose an increased risk of life-threatening arrhythmias in patients with asymptomatic preexcitation; hence, a separate approach could be considered, especially in patients willing to engage in high-intensity, endurance and competitive sports.

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“…При выборе КА в качестве способа лечения у пациентов с бессимптомным предвозбуждением и ДАВС низкого риска учитывают возможность выполнения процедуры в центрах с соответствующим опытом и предпочтение пациента [229,279,281,287,[300][301][302][303]. В современных условиях КА ДАВС, выполненная опытным оператором, обеспечивает высокую частоту излечения (>95%) при низком риске (<0,5%) серьезных осложнений [229,303]. β-АБ с доказанной способностью снижать смертность при ХСН со сниженной ФВ ЛЖ рекомендуются при кардиомиопатии, вызванной НЖТ, когда КА не удается или не применяется [276].…”

Section: клинические рекомендацииunclassified

2020 Clinical practice guidelines for Supraventricular tachycardia in adults

Бокерия¹,

Голухова²,

Попов³

et al. 2021

Russ J Cardiol

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Catheter ablation in ASymptomatic PEDiatric patients with ventricular preexcitation: results from the multicenter “CASPED” study

Cited by 17 publications

References 15 publications

Utilization of 3D mapping systems in interventional electrophysiology and its impact on procedure time and fluoroscopy—Insights from the “Go for Zero Fluoroscopy” project

Utilization of 3D mapping systems in interventional electrophysiology and its impact on procedure time and fluoroscopy—Insights from the “Go for Zero Fluoroscopy” project

Management of Young Athletes with Asymptomatic Preexcitation—A Review of the Literature

2020 Clinical practice guidelines for Supraventricular tachycardia in adults

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