PACES/HRS Expert Consensus Statement on the Use of Catheter Ablation in Children and Patients with Congenital Heart Disease

June 1, 2016This consensus statement provides up-to-date clinical practice guidelines for the use of catheter ablation in children 0–18 years of age with any arrhythmia, and in all patients with congenital heart disease.

Ablation
Pediatric
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In 2002, an expert consensus statement was published on catheter ablation in children and adults with congenital heart disease (CHD), based on a conference held at the North American Society of Pacing and Electrophysiology in the year 2000. Since publication in 2002, numerous technological improvements have been introduced, including catheter cryoablation, 3-dimensional (3D) mapping, percutaneous epicardial ablation, and high-powered ablation catheters using passive or active tip cooling. In addition, the uses of catheter ablation in pediatrics have expanded to include the management of virtually every arrhythmia, including atrial fibrillation (AF).

The Pediatric and Congenital Electrophysiology Society (PACES), in conjunction with the Heart Rhythm Society (HRS), has recently published related consensus guidelines and documents that include the following: the uses of catheter ablation for the management of asymptomatic Wolff-Parkinson-White (WPW) pattern found on the ECG (2012); adult patients with congenital heart disease (2014); and ventricular arrhythmias in children with a structurally normal heart (2014). This consensus statement provides up-to-date clinical practice guidelines for the use of catheter ablation in children 0–18 years of age with any arrhythmia, and in all patients with congenital heart disease. This statement attempts to also be consistent, where possible, with the 2012 and 2014 documents noted above. In case of conflict, the more recent publication of this document would indicate it supersedes the prior recommendations.

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