LEARNING-CURVE FOR RADIOFREQUENCY CATHETER ABLATION IN PEDIATRICS AT A SINGLE INSTITUTION

We examined the learning curve for radiofrequency ablation in pediatri cs at a single institution. The first 146 cases were retrospectively r eviewed, including patients less than or equal to 21 years old with a single tachycardia diagnosis who were undergoing radiofrequency ablati on for the first time. Data regarding demographics, electrophysiologic properties of the tachycardia, and procedural characteristics were ta bulated. Data were then analyzed for evidence of association between t hese characteristics, success, and experience. Results revealed that s uccess rates improved significantly with experience, reaching 85% succ ess for all cases after <100 cases attempted. Success for accessory pa thway tachycardias alone reached >93%. The number of cases of nonpathw ay tachycardias undertaken significantly increased as experience was g ained. Fluoroscopy time improved to 34 +/- 27 minutes after <100 cases . In conclusion, as experience was gained, (1) success rates showed a steep improvement; (2) the population undergoing radiofrequency ablati on clearly shifted to include more difficult diagnoses; and (3) fluoro scopy time significantly decreased.