Paediatric catheter ablation in a tertiary centre: contemporary characterization and clinical outcomes

Abstract Introduction Catheter ablation (CA) is now the preferred treatment for various arrhythmias in paediatric and adolescent patients. While technique and applications have advanced, much of the existing literature relies on earlier data, highlighting a need for updated insights into current practice. Purpose This study aims to characterise the procedures and outcomes of paediatric CA at a tertiary care centre. Methods We conducted a single-centre retrospective cohort study including all patients under 18 years old referred for CA at our centre from 2016 to 2023. Baseline characteristics, procedure details, and arrhythmia recurrence were recorded. Results A total of 204 patients (mean age 14.9 ± 2.81 years; 56% male) were included. Most had structurally normal hearts, with 9.8% presenting congenital heart disease. A majority (91%) were on antiarrhythmic medications before ablation. The procedure was performed under general anaesthesia in 85% of cases. Electroanatomical mapping was used in 95%, with a low average radiation dose (23.6 ± 7.81 µGym²), and a contact force catheter in 29%. The most common arrhythmias were atrioventricular reentrant tachycardia (61%) and atrioventricular nodal reentrant tachycardia (28%), followed by other supraventricular (8%) and ventricular tachycardias (3%). Ablation was performed in 91% of cases, with acute success in 98% of those. Repeat procedures were required in 2.9%, and no major complications occurred. Conclusion This study demonstrates that CA is highly effective and safe for paediatric arrhythmia patients, with a high success rate and low complication incidence, providing updated insights into the efficacy and safety of paediatric catheter ablation.