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Cryoablation with an 8-mm tip catheter for typical AVNRT in children: a single center 5-year experience
- Source :
- Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing. 62(1)
- Publication Year :
- 2019
-
Abstract
- In children with typical atrioventricular nodal reentrant tachycardia (tAVNRT), cryoablation is preferred over radiofrequency ablation (RFA) because of its safety profile and acceptable long-term success rates. In this study, we have assessed the utility of 8-mm tip cryocatheters for tAVNRT ablation in our center. All pediatric AVNRT patients who underwent cryoablation with an 8-mm tip cryocatheter in our center between 2013 and 2018 were included. EnSite™ (St. Jude Medical Inc., St. Paul, MN, USA) was used in all patients. A total of 120 patients (64 females, 53%) were included in this study, and the mean age was 13.9 years with a standard deviation of 2.5 years. Eleven patients (9.1%) had structural heart disease, and 12 patients (10%) had additional arrhythmia substrate. The mean number of effective cryolesions was 8 with a standard deviation of 2.3. Fluoroscopy was used in three patients (2.5%). There were minor complications in only four patients (3.3%)—transient first-degree atrioventricular block or transient incomplete right bundle branch block. Acute success rate of cryoablation was 108/120 (90%). In twelve patients, cryoablation was suboptimal, or it failed. The procedure was completed successfully with RFA in the same session in ten patients. Overall acute success rate of ablation (Cryo ± RFA) was 98.5%. During a mean follow-up period of 24.6 months with a standard deviation of 11.3 months, three patients had recurrence (2.5%). Time between the beginning of the effective cryolesion and termination of AVNRT was found associated with acute success of cryoablation (p = 0.013). Cryoablation of AVNRT with an 8-mm tip catheter in children appears to be safe, with an acceptable acute success rate and a low recurrence rate. A faster termination of AVNRT during the cryolesion, slowing down before ending with atrioventricular block, is a good indicator for acute success
- Subjects :
- Tachycardia
medicine.medical_specialty
Catheters
Heart disease
Adolescent
Radiofrequency ablation
medicine.medical_treatment
030204 cardiovascular system & hematology
Single Center
Cryosurgery
law.invention
03 medical and health sciences
0302 clinical medicine
law
Recurrence
Physiology (medical)
medicine
Fluoroscopy
Humans
Tachycardia, Atrioventricular Nodal Reentry
030212 general & internal medicine
Child
Retrospective Studies
medicine.diagnostic_test
business.industry
Cryoablation
medicine.disease
Ablation
Surgery
Treatment Outcome
Catheter Ablation
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Atrioventricular block
Subjects
Details
- ISSN :
- 15728595
- Volume :
- 62
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
- Accession number :
- edsair.doi.dedup.....16b3eca1f43e225b2e6dc9285693d670