title: Nonfluoroscopic catheter navigation for radiofrequency catheter ablation of supraventricular tachycardia in children.
abstract: BACKGROUND
  Radiofrequency catheter ablation (RCA) of supraventricular tachycardia (SVT) in children is highly successful but requires exposure to radiation. Nonfluoroscopic mapping systems may significantly reduce fluoroscopy time.
  
  
  METHODS
  Forty consecutive pediatric patients who underwent RCA for accessory pathways (AP) or AV nodal reentrant tachycardia (AVNRT) with use of a nonfluoroscopic navigation system (Ensite NavX) (group A) were compared retrospectively to 40 consecutive patients with similar diagnoses who underwent RCA with fluoroscopic guidance only (group B).
  
  
  RESULTS
  Group A (mean age 12.1+/-2.9 years, mean weight 47+/-13.9 kg) consisted of 11 patients (27.7%) with AVNRT and 29 (72.5%) with AP. Group B (mean age 10.9+/-3.1 years, mean weight 47.1+/-17.1 kg) consisted of 7 patients (17.5%) with AVNRT and 33 (82.5%) with AP. There were no significant differences in AP location, patients with congenital heart disease, and number of radiofrequency lesions. Fluoroscopy time was significantly shorter in group A than in group B (10.4+/-6.1, range 3.1-28.8 minutes, vs 24.9+/-16.0, range 4.4-82.0 minutes, P<0.0001). Procedure duration was also significantly shorter in group A than in group B (170+/-68.5, range 90-420 minutes, vs 218+/-69.3, range 90-360 minutes, P<0.0001). Initial success was 95% in group A and 100% in group B. Tachycardia recurrences occurred in two patients in group A (5%) and six patients in group B (15%). Final success, including repeat ablations for recurrences or failures, was 100% in both groups.
  
  
  CONCLUSIONS
  The use of a nonfluoroscopic system for catheter navigation significantly reduced fluoroscopy exposure and total procedure duration of RCA of common SVT substrates in children.
authors.affiliation: Division of Pediatric Cardiology, Onassis Cardiac Surgery Center, Athens, Greece. papagi@otenet.gr
authors.forename: John
authors.initials: J
authors.lastname: Papagiannis
authors.forename: Alexandros
authors.initials: A
authors.lastname: Tsoutsinos
authors.forename: George
authors.initials: G
authors.lastname: Kirvassilis
authors.forename: Ioanna
authors.initials: I
authors.lastname: Sofianidou
authors.forename: Theofili
authors.initials: T
authors.lastname: Koussi
authors.forename: Cleo
authors.initials: C
authors.lastname: Laskari
authors.forename: Maria
authors.initials: M
authors.lastname: Kiaffas
authors.forename: Sotiria
authors.initials: S
authors.lastname: Apostolopoulou
authors.forename: Spyridon
authors.initials: S
authors.lastname: Rammos
mesh_terms: D018780:Body Surface Potential Mapping / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013617:Tachycardia, Supraventricular / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome