Accessory pathway number and location, presence of SHD, ablation success, and recurrence were analyzed in consecutive patients from our center over a 16-year period.
In 1088 patients, 1228 pathways (36 % retrograde only) were mapped to the right side (TV) in 18 % , septum (S) in 39 % , and left side (MV) in 43 % . MultAP were present in 111 pts (10 % ), involving 250 distinct pathways. SHD tripled the risk of MultAP (26 % SHD vs 8 % no SHD, P < .001). Multivariable adjusted risk factors for MultAP included Ebstein's (OR 8.7[4.4-17.5], P < .001) and cardiomyopathy (OR 13.3[5.1-34.5], P < .001). Of 1306 ablation attempts, 94 % were acutely successful with an 8 % recurrence rate. Ablation success was affected by SHD (85 % vs 95 % for no SHD, P < .01) but not by MultAP (91 % vs 94 % for single, P = .24). Recurrence rate was higher for SHD (17 % SHD vs 8 % no SHD, P < .05) and MultAP (19 % MultAP vs 8 % single, P < .001).
MultAP are found in 10 % of pediatric patients, and are more common in SHD compared to those with normal hearts. Both the presence of MultAP and SHD negatively influence ablation outcomes.
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