First Latin American retrospective registry of cardiac ablation in pediatric and congenital heart disease patients. A LAHRS registry.

BACKGROUND

Catheter ablation has been proven as an effective and safe therapy for tachyarrhythmias in pediatric and congenital heart disease (CHD) patients. Although there are international registries on the use of catheter ablation in these populations, none of them include Latin American countries.

OBJECTIVES

To assess the clinical characteristics of pediatric and congenital heart disease patients undergoing catheter ablation procedures. Data obtained includes types of arrhythmias, techniques, success, complications and recurrence rates.

MATERIALS AND

METHODS

A descriptive and analytical retrospective observational study was performed. A closed coded online form available for 6 months was used. All electrophysiologists who practice pediatric electrophysiology in Latin America and were identified in a previous LAHSR's survey were invited to participate through Latin American Heart Rhythm Society (LAHRS) electronic media ( https://lahrs.org/ ). Participation was not mandatory, it was not encouraged by any economic or material goods, and an informed consent for the use of the data was required. Consecutive electrophysiological catheter procedures were included in children under 18 years of age or patients with CHD, regardless age, between 2017 and 2021.

RESULTS

Twenty physicians from 8 Latin American countries participated. A total of 1778 procedures were reported, 53% were male, mean age was 12.4 ± 5.1 years and 8.5% had congenital heart disease. An ablation was attempted in 87% of the patients, using a non-irrigated tip radiofrequency catheter in 68% of them, and a 3-D mapping system in 29%. Radiofrequency was the most commonly used energy source in 98% of the cases. The most frequent substrates were accessory pathways in 69.5% (61% were manifest), followed by AV nodal reentry in 16.5% and ectopic atrial tachycardia in 4%. Additionally, there were 3.8% atrial flutter, 3.8% ventricular tachycardias, 1.2% premature ventricular contractions. Ablation was considered acutely successful in 93% of the cases. Mean total procedural time was 92.1 ± 36.8 min and mean total fluoroscopy time was 16.3 ± 9.4 min. Complication rate was 1.8% and included complete AV block in 3 patients (0.2%). No deaths were reported. The recurrence rate was 8.5%.

CONCLUSIONS

In this first exclusively pediatric and congenital heart disease retrospective registry of catheter ablation in Latin America, a high rate of success and low incidence of complications was observed. This is in concordance with previously reported registries from other latitudes, proving that ablation is an effective and safe therapy in this group of patients.