Complicated congenital heart disease yields worse outcomes after catheter ablation

Atrioventricular nodal reentrant tachycardia can complicate treatment of patients with congenital heart disease and significantly increase risk for procedural failure, according to data presented at Cardiology 2017.

Daniel Beissel, MD, from Children’s Mercy Kansas City, and colleagues evaluated 109 patients (61 women; mean age, 22 years); 86% had congenital heart that resulted in right heart pressure and/or volume overload.

Based on severity of congenital heart disease, patients were divided in two groups: group A (n = 51) with complex congenital heart disease and group B (n = 58) with simple congenital heart disease. Atrioventricular nodal reentrant tachycardia was less common in group A than group B (72.5% vs. 89.5%, P = .024).

Overall, 75 participants had radiofrequency ablation, 32 had cryoablation and two had both.

Procedure times (251 minutes vs. 174 minutes; P = .0006) and fluoroscopy times (median, 20.8 minutes vs. 16.6 minutes; P = .037) were longer in group A vs. group B, according to the findings.

Group A had less acute success of ablation (82.4% vs. 96.5%; P = .04), a higher risk for atrioventricular block (13.7% vs. 0%; P = .004) and higher need for chronic pacing (12.5% vs. 0%; P = .008) compared with group B.

At follow-up (mean, 3.2 years), group B had 100% success compared with 86.9% success in group A (P = .004).

The researchers concluded that atrioventricular nodal reentrant tachycardia can complicate treatment of patients with congenital heart disease, and simple congenital heart disease has better outcomes after catheter ablation and less risks of procedure failure and atrioventricular block than complex congenital heart disease. – by Cassie Homer

Reference:

Beissel D, et al. Abstract 225. Presented at: Cardiology: the 20th Annual Update on Pediatric and Congenital Cardiovascular Disease; Feb. 22-26, 2017; Orlando, Fla.

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