Acute ablation success in pediatric patients was high across a range of center and operator volumes, with high-volume sites demonstrating the greatest likelihood of success for complex substrates, according to a recent study published in JACC: Advances.

Using data from ACC's IMPACT Registry, Dustin A. Nash, MD, et al., included 18,666 ablation procedures performed at 74 hospitals between April 2016 and March 2020. They explored associations between center and operator case volumes and acute success in pediatric ablations.

Overall, the acute success rate was 92%. There was no significant difference in success rates when comparing high- and very high-volume centers vs. medium- and low-volume centers (92% vs. 91%, respectively; p=0.24). Among patients with congenital heart disease (CHD) and patients with premature ventricular contractions/ventricular tachycardia, high volume centers demonstrated greater likelihood of success (odds ratio, 2.3 and 2.2, respectively).

Success rates by operator volume were 92.4% for low volume, 91.9% for medium volume, 92.2% for high volume and 94% for very high volume (p=0.015). No associations were identified between operator volume and acute success.

"The present data analysis confirms previously described factors associated with acute ablation success and failure," write the authors. "Both models found tachycardia mechanism and anatomic location to be significant correlates of acute success. Both models also demonstrated that presence of multiple targets (with the exception of the CHD subanalysis) and repeat procedures are associated with increased odds of acute ablation failure."