title: Cryoenergy catheter ablation: a new technique for treatment of permanent junctional reciprocating tachycardia in children.
abstract: BACKGROUND
  Permanent junctional reciprocating tachycardia (PJRT) is an infrequent form of reciprocating tachycardia, almost incessant from childhood and usually refractory to drug therapy. Radiofrequency catheter ablation currently is the first-line therapy for PJRT, but its application in the septal region may be associated with complications. In contrast, cryoenergy has several advantages, such as the ability to test the effects of ablation while the lesion is still forming, thus reducing the number of ineffective, useless, and potentially harmful lesions. The aim of this study was to investigate the potential clinical utility of percutaneous cryoenergy catheter ablation for treatment of pediatric patients with PJRT.
  
  
  RESULTS
  Four patients (age 14 +/- 5 years; mean +/- SD) with a clinical diagnosis of PJRT underwent catheter cryoablation. The ablation was successfully accomplished in 4 (100%) of 4 patients. The mean +/- SD number of cryoapplications was 1.8 +/- 0.8, and from 1 to 6 cryomappings were performed for each permanent cryolesion. The successful site was in the mid-septal region (2 patients), at the coronary sinus orifice (1 patient), and in the middle cardiac vein (1 patient). No complications with cryoablation were reported, nor was there prolongation of the AH interval during cryomapping or cryoablation. No pain was reported by patients during the cryoenergy catheter ablation procedure. PJRT recurrence occurred in 1 patient who underwent a second successful cryoablation procedure.
  
  
  CONCLUSIONS
  The outcomes of cryoenergy catheter ablation in these 4 patients treated for PJRT suggest that cryoablation is a safe, effective, and pain-free technique for treating pediatric patients with PJRT.
authors.affiliation: Division of Cardiology, Ospedale Mauriziano di Torino, Italy. gaitaf@libero.it
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
authors.forename: Antonio
authors.initials: A
authors.lastname: Montefusco
authors.forename: Riccardo
authors.initials: R
authors.lastname: Riccardi
authors.forename: Carla
authors.initials: C
authors.lastname: Giustetto
authors.forename: Stefano
authors.initials: S
authors.lastname: Grossi
authors.forename: Enrico
authors.initials: E
authors.lastname: Caruzzo
authors.forename: Francesca
authors.initials: F
authors.lastname: Bianchi
authors.forename: Laura
authors.initials: L
authors.lastname: Vivalda
authors.forename: Fulvio
authors.initials: F
authors.lastname: Gabbarini
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabro
mesh_terms: D000293:Adolescent; D017115:Catheter Ablation; D002648:Child; D002669:Child Welfare; D003452:Cryosurgery; D015716:Electrocardiography, Ambulatory; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000473:pathology / Q000601:surgery; D006346:Heart Septum / Q000473:pathology / Q000601:surgery; D006801:Humans; D007558:Italy; D008297:Male; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013613:Tachycardia, Ectopic Junctional / Q000601:surgery*; D013614:Tachycardia, Paroxysmal / Q000601:surgery*; D016896:Treatment Outcome