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.
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
Eric S
ES
Silver
Jennifer N A
JN
Silva
Scott R
SR
Ceresnak
Nancy A
NA
Chiesa
Edward K
EK
Rhee
Anne M
AM
Dubin
Kishor
K
Avasarala
George F
GF
Van Hare
Kathryn K
KK
Collins
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