Experience and Results During Transition from Radiofrequency Ablation to Cryoablation for Treatment of Pediatric Atrioventricular Nodal Reentrant Tachycardia

Background: Cryoablation has emerged as a new, theoretically safer, modality for treating atrioventricular nodal reentrant tachycardia (AVNRT). The purpose of this study is to compare procedural aspects and outcomes during the transition from radiofrequency (RF) ablation to cryoablation for pediatri...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 2008-04, Vol.31 (4), p.454-460
Main Authors: AVARI, JENNIFER N., JAY, KATHLEEN S., RHEE, EDWARD K.
Format: Article
Language:English
Subjects:
ablation
Adolescent
Adult
Body Surface Potential Mapping
Catheter Ablation - methods
Child
Child, Preschool
Cryosurgery - methods
electrophysiology-clinical
Female
Humans
Infant
Male
pediatrics
Retrospective Studies
SVT
Tachycardia, Atrioventricular Nodal Reentry - diagnosis
Tachycardia, Atrioventricular Nodal Reentry - surgery
Treatment Outcome
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Summary:Background: Cryoablation has emerged as a new, theoretically safer, modality for treating atrioventricular nodal reentrant tachycardia (AVNRT). The purpose of this study is to compare procedural aspects and outcomes during the transition from radiofrequency (RF) ablation to cryoablation for pediatric AVNRT. Methods: Data were obtained retrospectively from 80 consecutive pediatric patients who underwent AVNRT ablation from 10/2001– 4/2006 (RF n = 42, Cryo n = 38). Statistical analysis was performed using unpaired t‐test, chi‐square test, and analysis of variance. Results: RF ablations were performed anatomically in NSR while three different mapping techniques were used during cryoablation: ablation during AVNRT (26%), anatomic in NSR (48%), and anatomic with S1 S2 pacing (26%). There was no difference in the number or duration of lesions between the three cryo subgroups. Acute success was obtained in 95% of RF and 97% of cryo cases. There was no difference in the number of total, mapping, or full‐duration lesions between the RF and cryogroups. Despite accounting for longer cryolesion time, total ablation time (P < 0.001), mapping time (P = 0.002), and full duration lesion time (P < 0.001) were longer in the cryogroup. There was no significant difference in total procedure time; fluoroscopy time was shorter in the cryoablation group (P = 0.049). There was one confirmed recurrence of tachycardia in each group with a 2% recurrence rate. Conclusions: Cryoablation for treatment of pediatric AVNRT is as safe and efficacious as RF ablation. Although cryolesions are intrinsically longer in duration, total procedure times were not increased and fluoroscopy times were decreased compared to RF.
ISSN:0147-8389
1540-8159
DOI:10.1111/j.1540-8159.2008.01033.x