Limitations and future studies
Our study experienced limited power as a single institution
retrospective study with only 49 CF cases and 77 controls. As more
children undergo cardiac ablation with CF technology, larger cohorts for
both control and CF could elucidate patterns that were not statistically
significant in this small initial study. In addition, it would prove
useful to carry out a prospective multi-center study using a standard CF
ablation protocol. It has been shown with many new medical technologies,
especially technically intricate catheter ablation, that procedure times
significantly shorten as a function of experience.13By collecting data at multiple institutions, future research would
include more operators who may be more or less familiar with CF
technology. Widening this scope will allow a better analysis of CF
outcomes without interference of individual user variability.
Many AP locations were included in the present study, and we did not
find significant differences in procedure details or long-term outcomes.
Although our data is not significant, it is not unlike early studies of
CF in adult patients with results varying depending on the arrhythmia
specifics and study parameters. This may represent an era effect as
operators are becoming more familiar with the utility and limitations of
new technology. In future studies, differences between pathway locations
and details such as transseptal or retrograde approach may prove to be
important factors in determining differences in CF and traditional RF
ablation. Overall, further investigation with higher power studies is
necessary to show trends that may exist in the use of CF in pediatric AP
ablation.