Acute success of cryoablation of left-sided accessory pathways: a single institution study.
OBJECTIVE
To compare the acute success and recurrence rate of cryoablation for left-sided accessory pathways (AP) with controls who underwent radiofrequency ablation (RFA) at the same institution.


BACKGROUND
Catheter cryoablation of supraventricular tachycardia (SVT) is considered to be a safer alternative a compared with RFA. At our institution, cryoablation has become the primary interventional modality for all APs. The reported success rates of cryoablation for AP-mediated tachycardia have generally been less favorable than for RFA. However, the location of AP may influence cryoablation outcome. Furthermore, there are little data available on cryoablation of left-sided pathways.


METHODS
A chart review was performed for all patients undergoing cryoablation between August 2005 and August 2007. Twenty-nine patients (mean age 13 years, range 6-18 years) were identified with SVT secondary to left-sided AP. The data collected included patient age, height, weight, date of procedure, mapping, ablation and procedure time, pathway location, success, and recurrence. Cryoablation was performed via a transseptal approach. Procedural success and recurrence rate were compared with our most recent 28 patients undergoing RFA ablation.


RESULTS
Procedural success was achieved in 97% of patients in the cryoablation group, compared with 100% in the RFA control group. Recurrence rate in the cryoablation group was 1 of 24 (4.2%) patients compared with 4 of 28 (14%) patients in the RFA group over 12 months.


CONCLUSIONS
Cryoablation can be safely and effectively used in the treatment of left-sided AP. Long-term outcomes remain to be seen.
Gist
Katja M
KM
Division of Pediatric Cardiology, Heart Center, Akron Children's Hospital, One Perkins Square, Akron, OH 44308, USA. gist.kat@gmail.com
Bockoven
John R
JR
Lane
John
J
Smith
Grace
G
Clark
John M
JM
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006329:Heart Conduction System / Q000002:abnormalities* / Q000601:surgery*; D006801:Humans; D008297:Male; D013617:Tachycardia, Supraventricular / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome