ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2026
Ablation of manifest accessory pathways in pediatric patients: comparison between conventional and non‑radiological navigation techniques.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Corrections and comments
- Erratum issued
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20 authors.
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Abstract
The purpose was to evaluate clinical characteristics and outcomes of patients under 18 years of age submitted for an electrophysiological study (EPS) for the presence of a manifest accessory pathway (AP) and to compare conventional versus non‑radiological navigation system (NRNS) technics. An observational, multicenter and analytical study was conducted using Latin American Heart Rhythm Society´s pediatric registry. A total of 746 patients underwent EPS due to manifest AP and were all included. The mean age was 10,5 ± 4,4 years, and 471 (63.1%) were male. There were 68 (9,1%) with a structural heart disease and Ebstein’s anomaly was the most frequent congenital heart disease (CHD). Ablation was attempted in 734 (98.4%) and was successful in 694 (94.6%). A NRNS was used in 218 (28.8%) procedures and radiofrequency was used in 728 (97.6%). There were 22 (2.9%) complications, including complete AV block requiring pacemaker implantation in 2 (0.3%) cases. No deaths were reported. After at least one-year follow-up there were 64 (2.2%) patients with manifest AP recurrence. Patients in NRNS group were older (11,6 ± 3,7 vs., 9,6 ± 4,7 years, p < 0,001), had more CHD (13,5% vs. 6,2%, p = 0,004), required less fluoroscopy (6,9 ± 5,9 vs. 20,2 ± 16,5 min, p < 0,001) and achieved higher acute success (99,1% vs. 92,7%, p < 0,001). There were no differences in complications or recurrences. In the multivariate analysis, only the use of NRNS was independently associated with greater effectiveness (p = 0.019). This study reports clinical characteristics, EPS and ablation in children with manifest AP. Ablation using a NRNS was more effective and required less fluoroscopy, without compromising safety.Capsule Summary: In 746 children undergoing EPS for manifest accessory pathways, ablation showed high effectiveness and low complication rates. Non-radiological navigation systems (NRNS) achieved higher acute success and markedly reduced fluoroscopy without compromising safety. Multivariate analysis identified NRNS as an independent predictor of greater effectiveness.
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