Work

Current trends in outcome of thermal catheter ablation for accessory pathways: A retrospective, single center study of 500 children and adults

Year: 2026

Type: preprint

Abstract: Purpose This study aimed to describe updated trends in patient characteristics, procedure efficacy and safety in patients with accessory pathway (AP) treated with catheter ablation using thermal ablation in a single center in Denmark. Methods This retrospective single-center cohort study included 500 patients with AP who underwent catheter ablation with thermal energy at Rigshospitalet, Copenhagen from 2019-2024 (565 procedures). Data was collected from electronic patient records until 1 st of October 2024, and in a subset until May 2025. Median follow-up time was 191 days. Results Most patients were males (290, (58%)), and at the time of first ablation the mean age was 26 years; 217 patients (43%) were below 18 years. Acute procedural success was achieved in 464 patients (92.8%), of whom recurrence occurred in 49 patients (10.7%) during follow-up. Septal AP was associated with lower acute success (OR=0.22, p=0.003) compared to non-septal AP. Predictors for later recurrence was septal AP (14%, OR=3.21, p=0.005), right non-septal AP (27.8%, OR=9.5, p<0.00001), and multiple APs (33.3%, OR=7.6, p=0.002), compared to left non-septal AP (4.9%). Woman had significantly lower odds of recurrence compared to men (OR=0.36, p=0.008). One patient developed complete atrio-ventricular-block (AV-block) and two cases of cardiac tamponade were seen. Conclusion Catheter ablation of AP using thermal energy remains a highly effective and safe treatment for both pediatric and adult patients. However, despite improved technology, septal and right-sided pathways remain predictors for later recurrence.

Source: Research Square

DOI: 10.21203/rs.3.rs-11159588/v1