Catheter Ablation for Supraventricular Tachycardia in Infants: A Systematic Review and Selective Meta-Analysis.
Karin Vasic, Aleksandar Markovic
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In 30 seconds
This systematic review and selective meta-analysis assessed catheter ablation outcomes for supraventricular tachycardia in infants aged 12 months or younger, generally considered for drug-refractory or life-threatening cases. Five studies contributed to the qualitative review; four observational studies, comprising 57 infants, were pooled using a single-arm random-effects model. The pooled acute procedural success rate was 93% (95% CI 84%-98%), while the pooled complication rate was 7% (95% CI 3%-17%). Arrhythmia recurrence was reported in 9% (95% CI 4%-19%) during 6-24 months of follow-up.
Key findings
- Pooled acute procedural success was 93% (95% CI 84%-98%; I 2 ≤5%) across four studies comprising 57 infants.
- The pooled complication rate was 7% (95% CI 3%-17%; I 2 ≤5%).
- Arrhythmia recurrence occurred in 9% of infants (95% CI 4%-19%) during 6-24 months of follow-up.
- No permanent atrioventricular block or procedure-related deaths were reported.
Why it matters
Infant ablation is undertaken in a population for whom pharmacological therapy is usually first-line and procedural decisions require careful risk assessment. These pooled findings provide an estimate of reported success, complications, and recurrence in selected infants, while underscoring that the evidence base is too limited to establish outcomes broadly or resolve optimal patient selection and timing.
What to keep in mind
Evidence came from a small number of highly selected observational studies, with potential publication and referral bias; the authors call for larger prospective multicenter studies.