Cryoablation with an 8-mm tip catheter for pediatric atrioventricular nodal reentrant tachycardia is safe and efficacious with a low incidence of recurrence.
BACKGROUND
Cryoablation with 4- and 6-mm tip ablation catheters has been demonstrated to be safe and effective in the treatment of atrioventricular nodal reentrant tachycardia (AVNRT) in pediatric patients, albeit with a higher rate of clinical recurrence. Limited information is available regarding efficacy, mid-term outcomes, and complications related to the use of the 8-mm Freezor Max Cryoablation catheter (Medtronic, Minneapolis, MN, USA) in pediatric patients.


METHODS
We performed a retrospective review of all pediatric patients with normal cardiac anatomy who underwent an ablation procedure for treatment of AVNRT using the 8-mm tip Cryoablation catheter at three large pediatric academic arrhythmia centers.


RESULTS
Cryoablation with an 8-mm tip catheter was performed in 77 patients for treatment of AVNRT (female n = 40 [52%], age 14.8 +/- 2.2 years, weight 62.0 +/- 13.9 kg). Initial procedural success was achieved in 69 patients (69/76, 91%). Transient second- or third-degree atrioventricular (AV) block was noted in five patients (6.5%). There was no permanent AV block. Of the patients successfully ablated with Cryotherapy, there were two recurrences (2/70, 2.8%) over a follow-up of 11.6 +/- 3.3 months.


CONCLUSIONS
Cryoablation with an 8-mm tip ablation catheter is both safe and effective with a low risk of recurrence for the treatment of AVNRT in pediatric patients.
Silver
Eric S
ES
Division of Pediatric Cardiology, Morgan Stanley Children's Hospital of New York Presbyterian Hospital, Columbia University, New York, New York 10032, USA. silvee02@gmail.com
Silva
Jennifer N A
JN
Ceresnak
Scott R
SR
Chiesa
Nancy A
NA
Rhee
Edward K
EK
Dubin
Anne M
AM
Avasarala
Kishor
K
Van Hare
George F
GF
Collins
Kathryn K
KK
D000293:Adolescent; D054537:Atrioventricular Block / Q000209:etiology; D002648:Child; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome