Cryoablation with an 8-mm-Tip Catheter for Right-Sided Accessory Pathways in Children


Tanidir I. C., Ergul Y., Ozturk E., Dalgic F., Kiplapinar N., Tola H. T., ...More

PACE - Pacing and Clinical Electrophysiology, vol.39, no.8, pp.797-804, 2016 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 39 Issue: 8
  • Publication Date: 2016
  • Doi Number: 10.1111/pace.12892
  • Journal Name: PACE - Pacing and Clinical Electrophysiology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.797-804
  • Keywords: children, cryoablation, catheter ablation, accessory pathway, atrioventricular reentrant tachycardia
  • Istanbul Medipol University Affiliated: Yes

Abstract

Background: Cryoablation is increasingly utilized in children because of its safety profile. Recently, larger catheter tips have been more widely used to improve long-term success rates. The aim of this study was to assess the safety and efficacy of 8-mm-tip catheters for cryoablation of right-sided accessory pathways (APs) in children. Methods: Electrophysiological procedures were performed using the EnSite™ system (St. Jude Medical Inc., St. Paul, MN, USA). Results: Between July 2010 and July 2014, 54 patients (mean age: 13.1 ± 3.7 years) underwent cryoablation using an 8-mm-tip catheter. In 18 of 54 (33%) patients where an 8-mm-tip catheter was the first-choice catheter, the success rate was 18 of 18 (100%). There was a history of previous failed attempts or recurrence with radiofrequency ablation and/or 6-mm-tip cryoablation in 36 of 54 (67%) patients. The success rate in these patients was 24 of 36 (67%). No fluoroscopy was used in 34 of 54 procedures. The recurrence rate was six of 42 (14%) during a mean follow-up period of 32 ± 15 months. In one patient, transient atrioventricular block occurred. Conclusions: Cryoablation with an 8-mm-tip catheter for right-sided APs in children who weigh over 40 kg appears to be safe and acutely effective in cases where conventional ablation methods fail and also as a first choice for ablation procedure. However, the recurrence rate still seems to be high.