1. Single center experience of fluoroless AVNRT ablation guided by electroanatomic reconstruction in children and adolescents.
- Author
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Scaglione M, Ebrille E, Caponi D, Blandino A, DI Donna P, Siboldi A, Bertero G, Anselmino M, Raimondo C, Sardi D, Gabbarini F, Marasini M, and Gaita F
- Subjects
- Adolescent, Child, Cryosurgery adverse effects, Feasibility Studies, Female, Humans, Reproducibility of Results, Sensitivity and Specificity, Surgery, Computer-Assisted adverse effects, Tomography, X-Ray Computed methods, Treatment Outcome, Body Surface Potential Mapping methods, Cryosurgery methods, Surgery, Computer-Assisted methods, Tachycardia, Atrioventricular Nodal Reentry diagnosis, Tachycardia, Atrioventricular Nodal Reentry surgery
- Abstract
Background: Anatomical considerations and risks related to x-ray exposure make atrioventricular nodal reentrant tachycardia (AVNRT) ablation in pediatric patients a concerning procedure. We aimed to evaluate the feasibility, safety, and efficacy of performing fluoroless slow-pathway cryoablation guided by the electroanatomic (EA) mapping in children and adolescents., Methods: Twenty-one consecutive patients (mean age 13.5 ± 2.4 years) symptomatic for AVNRT were prospectively enrolled to right atrium EA mapping and electrophysiological study prior to cryoablation. Cryoablation was guided by slow-pathway potential and performed using a 4-mm-tip catheter., Results: Sustained slow-fast AVNRT was inducible in all the patients with a dual AV nodal physiology in 95%. Acute success was achieved in 100% of the patients with a median of two cryo-applications. Fluoroless ablation was feasible in 19 patients, while in two subjects 50 seconds and 45 seconds of x-ray were needed due to difficult progression of the catheters along the venous system. After a mean follow-up of 25 months, AVNRT recurred in five patients. All the recurrences were successfully treated with a second procedure. In three patients, a fluoroless cryoablation with a 6-mm-tip catheter was successfully performed, while in the remaining two patients, a single pulse of 60 seconds of radiofrequency energy was applied under fluoroscopic monitoring. No complications occurred., Conclusions: Combination of EA mapping systems and cryoablation may allow to perform fluoroless slow-pathway ablation for AVNRT in children and adolescents in the majority of patients. Fluoroless slow-pathway cryoablation showed a high efficacy and safety comparable to conventional fluoroscopy guided procedures., (©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.)
- Published
- 2013
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