Epicardial ablation of tachyarrhythmia in children: Experience at two academic centers

Upadhyay, Shailendra; Walsh, Edward P.; Cecchin, Frank; Triedman, John K.; Villafañe, Juan; Saul, J. Philip

doi:10.1111/pace.13152

Cited by 9 publications

(5 citation statements)

References 37 publications

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“…In this regard, contact force catheter could be an alternative to or the last chance before a questionable epicardial approach in children. 16 The absence of recurrences was also noted in all ablations performed in the middle cardiac vein, irrespectively of catheter used. These data confirm that when anomalous myocardial fibres extending from the coronary sinus to the ventricle run along the middle cardiac vein, the placement of the catheter in this vein allows us to be close to the accessory pathway.…”

Section: Discussionmentioning

confidence: 78%

3D transvenous radiofrequency ablation of manifest epicardial posterior-septal accessory pathways in children: Can technology innovations improve the outcome?

et al. 2021

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Introduction: The aim of the study was to revise our more recent experience about epicardial posterior-septal accessory pathways radiofrequency transcatheter ablation in children and young patients using a transvenous approach through the coronary sinus, to understand if new mapping and ablation technologies can increase success rate and safety. Methods and results: Twenty children (mean age 13 ± 3 years) with epicardial posterior-septal accessory pathways (14 in coronary sinus and 6 in the middle cardiac vein) underwent radiofrequency transcatheter ablation with CARTO-3® system with help of the CARTO-Univu® module. Acute success rate was 73%. No patient was lost to follow-up (mean time 11.4 ± 9 months). The recurrence rate was 19%. Two patients underwent a successful redo-procedure; the overall long-term success rate was 65%. Navistar® catheter presented the highest acute success rate in the coronary sinus. Navistar SmartTouch® was the only catheter that did not present recurrences after the acute success, and it was successfully used in two patients previously unsuccessfully treated with a Navistar ThermoCool®. Acute success rate was 79% without image integration with angio-CT, while it was 63% after the introduction of CARTO-Merge®. Conclusion: Epicardial posterior-septal accessory pathways can be definitively eliminated by transvenous radiofrequency transcatheter ablation in more than half of the cases in children. Acute success rate does not seem to depend on catheters used, but contact-force catheter seems to be useful in cases with recurrences. Image integration with cardiac-CT does not increase success rate, but it is useful to detect coronary sinus alterations to better guide ablation strategy.

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Section: Discussionmentioning

confidence: 78%

3D transvenous radiofrequency ablation of manifest epicardial posterior-septal accessory pathways in children: Can technology innovations improve the outcome?

et al. 2021

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“…Epicardial ablation is a tool utilized more commonly in the adult population than in pediatrics. 43 However, the pericardial access technique for these ablations remains risky with a significant chance for major complications. These include inadvertent ventricular perforation, pleural injury, phrenic nerve injury or coronary injury that can lead to pericardial effusions, tamponade, or even death.…”

Section: Discussionmentioning

confidence: 99%

“…Access to the pericardial space may be used for applications beyond pacemaker and ICD leads. Epicardial ablation is a tool utilized more commonly in the adult population than in pediatrics 43 . However, the pericardial access technique for these ablations remains risky with a significant chance for major complications.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous epicardial pacing in infants using direct visualization: A feasibility animal study

Kumthekar

Opfermann

Mass

et al. 2023

Cardiovasc electrophysiol

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This study was supported by two research grants, one from the Pediatric and Congenital Electrophysiology Society (PACES) and another from the American Academy of Pediatrics (AAP) Children's Heart Foundation (CHF). Justin D. Opfermann and Charles I. Berul are co-founders of PeriCor, LLC. Charles I. Berul is a consultant for Medtronic. Justin D. Opfermann, Paige N. Mass, Dr. Charles I. Berul, and Dr. Rohan N. Kumthekar are also members of and hold Shares of Stock Options in PeriCor, LLC. The results of the study discussed in this publication could affect the value of PeriCor, LLC. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict-of-interest policies.

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“…[ 5 ] Upadhyay et al. [ 6 ] described 9 pediatric patients who underwent 10 epicardial ablation procedures between 2002 and 2013. Accessory pathway ablation was performed in only 3 of these patients, of whom 1 needed endocardial re-approach for success.…”

Section: Discussionmentioning

confidence: 99%

Successful Ablation of an Epicardial Accessory Pathway via the Subxiphoid Approach in a Child

Dalili

2021

Indian Pacing and Electrophysiology Journal

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Epicardial ablation of tachyarrhythmia in children: Experience at two academic centers

Cited by 9 publications

References 37 publications

3D transvenous radiofrequency ablation of manifest epicardial posterior-septal accessory pathways in children: Can technology innovations improve the outcome?

3D transvenous radiofrequency ablation of manifest epicardial posterior-septal accessory pathways in children: Can technology innovations improve the outcome?

Percutaneous epicardial pacing in infants using direct visualization: A feasibility animal study

Successful Ablation of an Epicardial Accessory Pathway via the Subxiphoid Approach in a Child

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