Radiofrequency ablation for pre-excitation syndromes and AV nodal re-entrant tachycardia

Cryoablation Versus Radiofrequency Ablation in the Management of Pediatric Supraventricular Tachyarrhythmia: A Systematic Review and Meta-Analysis

Supraventricular tachycardia (SVT) is a common arrhythmia in pediatric patients, often requiring catheter ablation for effective treatment. Two primary techniques, radiofrequency ablation (RFA) and cryoablation (CA), are widely used; however, their comparative safety and efficacy remain subjects of debate, with no clear consensus on the preferred approach. This systematic review and meta-analysis aimed to evaluate and compare the efficacy and safety of RFA and CA in pediatric patients with SVT, focusing on the primary outcomes of acute success and recurrence rates. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies included comparative analyses such as randomized controlled trials, non-randomized trials, and observational studies that specifically evaluated RFA and CA in pediatric populations with SVT. Exclusion criteria included studies involving adult populations, those without comparative groups, case reports, case series, and conference abstracts. Data extracted from the included studies encompassed acute success rates, recurrence rates, and complication rates, providing a comprehensive overview of the performance and safety profiles of RFA and CA in this patient group. Acute success rates were high for both techniques (RFA: 96.3%, CA: 94.9%; p = 0.137). However, RFA demonstrated a significantly lower recurrence rate (7.9% vs. 14.4%; odds ratio (OR): 0.408, 95% CI: 0.242-0.689, p < 0.001). CA was associated with longer procedure durations (mean difference: 9.684 minutes, p = 0.437) and significantly reduced fluoroscopy times (mean difference: 6.566 minutes, p = 0.032). Complication rates were comparable, with a non-significant trend favoring RFA (OR: 0.363, p = 0.112). Overall, both RFA and CA were found to be effective and safe for pediatric SVT. RFA offers durable results with lower recurrence rates, while CA minimizes fluoroscopy time, thereby reducing radiation exposure. Treatment selection should be individualized, considering factors such as the type and location of the arrhythmia as well as specific procedural risks.

Impact on a Person’s Daily Life During Episodes of Supraventricular Tachycardia

Purpose: To describe the impact of episodes of supraventricular tachycardia (SVT) on a person’s daily life from a holistic perspective. Method: A deductive descriptive design was used. Twenty semistructured interviews (12 women and 8 men) were conducted before planned ablation of SVT and were analyzed using qualitative content analysis. Results: Living with SVT had a complex impact on daily life. Initially, the patients described an inhibited existence due to demands to give up things that they had previously been doing, in case the unpredictable episodes of SVT would occur. The episodes caused fatigue and worry, which together created a barrier for living life to the full by making the person give up undertakings. The patients constantly needed to find short-term and long-term strategies to prevent new episodes from happening. Conclusion: Episodes of SVT entail a complex life situation as the person’s entire existence is affected in daily life. To understand the impact of SVT on daily life, nurses and other health care professionals need increased knowledge and understanding to be able to provide support through relevant information and take optimal care measures.