Does ablation of supraventricular tachycardia in children with a structurally normal heart improve quality of life?

Introduction. Ablation has become first-line therapy for managing many pediatric patients with atrioventicular accessory pathway or atrioventricular nodal-mediated supraventricular tachycardia (SVT). Studies to date have all focused on elimination of the SVT substrate; yet, there are no studies to document whether this results in improved quality of life (QoL) scores. Objective. The objective of this study was to evaluate whether a successful catheter ablation improved QoL scores in pediatric patients. Patient and Methods. Pediatric patients between the age of 5 and 18 years with structurally normal hearts and re-entry SVT that were referred to the electrophysiology laboratory between October 2004 and June 2006 at the Children's Healthcare of Atlanta were eligible to be enrolled in the study. The Pediatric Quality of Life Inventory cardiac model questionnaire was administered to patients prior to and 6 months following catheter ablation. Areas evaluated were physical, emotional, social, school, and psychosocial function. The paired t-test was used to test the difference between pre- and post-time points for the study groups. P value <.05 was considered significant. Results. Forty-three patients consented to initial enrollment and returned the initial questionnaires. Seven patients did not have ablations performed during the electrophysiology study and therefore were excluded from further analysis. Complete pre- and post-ablation data were available for 27 patients. Comparing pre-ablation data with post-ablation data, there was significant improvement in all measured areas following successful elimination of tachycardia substrate. Patients reported lowest social and physical functioning scores pre-ablation. The greatest reported improvement post-ablation was in physical functioning. Conclusion. Successful elimination of SVT substrate results in improved pediatric QoL scores as reported by patients.