Meta-Analysis of the Efficacy and Safety of Radiofrequency Catheter Ablation for Pediatric Paroxysmal Supraventricular Tachycardia.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiology Pub Date : 2024-09-05 DOI:10.1159/000541178

Xue Zhang, Yue Yuan

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引用次数: 0

Abstract

Introduction: This meta-analysis was to evaluate the efficacy and safety of radiofrequency catheter ablation (RFCA) in treating children with paroxysmal supraventricular tachycardia (PSVT).

Methods: From inception to December 16, 2023, PubMed, Embase, Cochrane Library, Web of Science, CNKI (China National Knowledge Infrastructure), VIP (Chinese Science and Technology Periodical Database), and WanFang were searched for this meta-analysis. Children under the age of 18 diagnosed with atrioventricular reentrant tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT) were enrolled. The outcomes included the success rate of RFCA, the recurrence rate of PSVT following RFCA treatment, and any complications associated with the procedure. Newcastle-Ottawa Scale (NOS) was used to assess the quality of studies. The outcome data were represented as rates (RATE) and corresponding 95% confidence intervals (CIs). Subgroup analyses were conducted based on regions and follow-ups.

Results: Fourteen articles encompassing 6,032 children were included in the study. RFCA demonstrated remarkable efficacy in children patients, achieving success rates of 98% (RATE: 0.98, 95% CI: 0.96-0.99) for AVRT and 99% (RATE: 0.99, 95% CI: 0.98-1.00) for AVNRT. The analysis also reveals that post-RFCA, the recurrence rates for AVRT were 5% (RATE: 0.05, 95% CI: 0.03-0.07), while for AVNRT, they were slightly lower at 4% (RATE: 0.04, 95% CI: 0.02-0.08). In the subset of Asian children patients, these recurrence rates were observed to be 5% for AVRT and 3% for AVNRT. Monitoring for a duration of up to 12 months of post-RFCA indicated recurrence rates of 4% for AVRT and 3% for AVNRT. However, for follow-up periods extending beyond 1 year, there was a slight increase in these rates to 4% for AVRT and 6% for AVNRT. Additionally, the complication rates associated with RFCA in the children population were relatively minimal, recorded at 2% (RATE: 0.02, 95% CI: -0.01-0.06) for AVRT and 1% (RATE: 0.01, 95% CI: 0.00-0.02) for AVNRT.

Conclusion: RFCA appears to be a highly effective and safe treatment option for AVRT and AVNRT in children, with high success rates and relatively low recurrence and complication rates. However, long-term follow-up may be necessary to monitor for potential recurrences. These findings are valuable for clinicians and patients in making informed decisions about the treatment of these cardiac arrhythmias in pediatric patients.

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射频导管消融治疗小儿阵发性室上性心动过速的有效性和安全性的 Meta 分析。

导言：本荟萃分析旨在评估射频导管消融术（RFCA）治疗儿童阵发性室上性心动过速（PSVT）的有效性和安全性：方法：从开始到2023年12月16日，检索了PubMed、Embase、Cochrane Library、Web of Science、CNKI（中国国家知识基础设施）、VIP（中国科技期刊数据库）和万方数据库，以进行本荟萃分析。研究对象为18岁以下确诊为房室返流性心动过速（AVRT）和房室结返流性心动过速（AVNRT）的儿童。研究结果包括 RFCA 的成功率、RFCA 治疗后 PSVT 的复发率以及与手术相关的并发症。纽卡斯尔-渥太华量表（NOS）用于评估研究质量。结果数据以率（RATE）和相应的 95% 置信区间（CI）表示。根据地区和随访情况进行了分组分析：研究共纳入 14 篇文章，涉及 6032 名儿童。RFCA对儿童患者的疗效显著，AVRT的成功率为98%（RATE：0.98，95% CI：0.96至0.99），AVNRT的成功率为99%（RATE：0.99，95% CI：0.98至1.00）。分析还显示，RFCA 后 AVRT 的复发率为 5%（RATE：0.05，95% CI：0.03 至 0.07），而 AVNRT 的复发率略低，为 4%（RATE：0.04，95% CI：0.02 至 0.08）。据观察，在亚裔儿童患者中，AVRT 的复发率为 5%，AVNRT 为 3%。对 RFCA 术后长达 12 个月的监测显示，AVRT 的复发率为 4%，AVNRT 为 3%。然而，随访期超过一年后，复发率略有上升，其中 AVRT 为 4%，AVNRT 为 6%。此外，RFCA在儿童人群中的并发症发生率相对较低，AVRT为2%（RATE：0.02，95% CI：-0.01至0.06），AVNRT为1%（RATE：0.01，95% CI：0.00至0.02）：RFCA似乎是治疗儿童AVRT和AVNRT的一种高效、安全的方法，成功率高，复发率和并发症发生率相对较低。不过，可能需要长期随访以监测潜在的复发。这些研究结果对临床医生和患者在治疗小儿心律失常时做出明智决定很有价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology 医学-心血管系统

CiteScore

3.40

自引率

5.30%

发文量

审稿时长

1.5 months

期刊介绍： ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.