Beyond Rhythm Control: Health-Related Quality of Life and Attention–Behavioral Outcomes After Catheter Ablation in Children with Supraventricular Tachycardia

Background: Symptomatic supraventricular tachycardia (SVT) in childhood may adversely affect physical, emotional, social, and school functioning during critical developmental periods. Although catheter ablation is an established and effective treatment for pediatric SVT, outcome evaluations have largely focused on rhythm control, with limited attention to neurobehavioral functioning. Objectives: To evaluate changes in health-related quality of life (HRQoL) following catheter ablation in children with symptomatic SVT and to characterize post-ablation attention–behavioral outcomes, with particular emphasis on age- and sex-related patterns. Methods: This retrospective–prospective observational cohort study included 59 children and adolescents (aged 4–17 years) who underwent successful catheter ablation for symptomatic SVT between January 2022 and December 2025. Pre-ablation HRQoL data were obtained retrospectively, while post-ablation HRQoL, structured psychiatric interviews, and attention–behavioral assessments were conducted approximately six months after ablation. HRQoL was assessed using the Pediatric Quality of Life Inventory (PedsQL™ 4.0). Psychiatric diagnoses were established using the Schedule for Affective Disorders and Schizophrenia for School-Age Children—Present and Lifetime Version (K-SADS-PL), and attention–behavioral symptoms were evaluated using the DSM-IV Based Disruptive Behavior Disorders Screening and Assessment Scale (DBDS). Results: Significant improvements were observed across all HRQoL domains following catheter ablation (physical, emotional, social, and school functioning; all p < 0.001). In contrast, attention–behavioral outcomes demonstrated greater heterogeneity. Boys exhibited higher post-ablation inattention scores than girls, and increasing age was associated with higher inattention and conduct-related problem scores. Although a subset of participants exceeded predefined DBDS cutoff values, mean attention–behavioral scores were generally within non-clinical ranges. Approximately 30% of participants met criteria for at least one psychiatric diagnosis at follow-up, most commonly anxiety disorders. Conclusions: Catheter ablation in children with symptomatic SVT is associated with marked improvements in health-related quality of life but does not uniformly normalize attention and behavioral functioning. These findings highlight the importance of incorporating brief neurobehavioral screening into routine post-ablation follow-up and support a more comprehensive, patient-centered approach to pediatric arrhythmia care.