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 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 S(1) S(2) 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.
Avari
Jennifer N
JN
Department of Pediatric Cardiology, St. Louis Children's Hospital/Washington University School of Medicine, St. Louis, Missouri 63110, USA. AVARI_J@KIDS.WUSTL.EDU
Jay
Kathleen S
KS
Rhee
Edward K
EK
D000293:Adolescent; D000328:Adult; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome