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Ablation is the treatment of choice for WPW in children. With increased concern regarding healthcare costs, efforts to reduce cost while maintaining quality are paramount. We present a novel 3-catheter approach to the ablation of left-sided accessory pathways (AP) in children with WPW.
A retrospective review from 2008 to 2012 of pts < 21 yrs with WPW who underwent a 3-catheter RF ablation of a left-sided AP (ablation, RV apical, and coronary sinus decapolar catheters). This 3-catheter group was compared to an age and gender matched control group who underwent a standard 5-catheter RF ablation for the treatment of left-sided WPW or concealed AP. Demographics, ablation outcomes and costs were compared between groups.
28 pts met inclusion criteria with 28 control pts. The groups did not differ in gender, age, weight, or BSA (Table 1). Locations of the AP on the mitral annulus were similar between the groups. All pts were ablated transseptally. 28/28 in the 3 catheter group (100%) and 27/28 (96%) controls were acutely successfully ablated. No complications were encountered. There was no difference in procedural time, time to loss of AP conduction, or # of RF applications (Table 1). The catheter cost using 3-catheters was $1940 versus $2620 for the controls, yielding a savings of $680/case.
Ablation in pts with WPW and a left-sided AP can be performed using 3 rather than the conventional 4-5 catheter approach with similar efficacy and safety while offering significant cost savings.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Congenital Cardiology Solutions: Congenital Electrophysiology and Genetics
Abstract Category: 13. Congenital Cardiology Solutions: Pediatric
Presentation Number: 1247-125
- 2013 American College of Cardiology Foundation