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Patient and Procedural Correlates of Fluoroscopy Use During Catheter Ablation in the Pediatric and Congenital Electrophysiology Lab.
Kean, Adam C; LaPage, Martin J; Yu, Sunkyung; Dick, Macdonald; Bradley, David J.
Afiliação
  • Kean AC; Pediatrix Cardiology Associates of New Mexico, Albuquerque, NM, USA.
  • LaPage MJ; Division of Pediatric Cardiology, University of Michigan, Ann Arbor, Mich, USA.
  • Yu S; Division of Pediatric Cardiology, University of Michigan, Ann Arbor, Mich, USA.
  • Dick M; Division of Pediatric Cardiology, University of Michigan, Ann Arbor, Mich, USA.
  • Bradley DJ; Division of Pediatric Cardiology, University of Michigan, Ann Arbor, Mich, USA.
Congenit Heart Dis ; 10(3): 281-7, 2015.
Article em En | MEDLINE | ID: mdl-25099613
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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ablação por Cateter / Cardiopatias Congênitas Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ablação por Cateter / Cardiopatias Congênitas Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Idioma: En Ano de publicação: 2015 Tipo de documento: Article