title: Safety and results of cryoablation in patients <5 years old and/or <15 kilograms.
abstract: Current recommendations discourage elective radiofrequency ablation in patients <5 years old and/or weighing <15 kg, primarily because of the greater complication rate. To describe the current use, complications, and immediate outcomes of cryoablation in this patient population, a multicenter retrospective review of all patients <5 years old and/or weighing <15 kg who were treated with cryoablation for arrhythmia was performed. Eleven centers contributed data for 68 procedures on 61 patients. Of those, 34% were elective and 24% (n = 16) were both cryoablation and radiofrequency ablation. The median age and weight at ablation was 3.5 years (range 8 days to 9.9 years) and 15.2 kg (range 2.3 to 23), respectively. Congenital heart disease was present in 23% of the patients. The immediate success rate of cryoablation alone was 74%. No major complications occurred with cryoablation only; however, 2 of the 16 patients who underwent cryoablation and radiofrequency ablation had major complications. Of the 50 patients receiving cryoablation, 8 (16%) had variable degrees of transient atrioventricular block. The recurrence rate was 20% after cryoablation and 30% after cryoablation plus radiofrequency ablation. In conclusion, cryoablation appears to have a high safety profile in these patients. Compared to older and larger patients, the efficacy of cryoablation in this small, young population was lower and the recurrence rates were higher. Cryoablation's effect on the coronary arteries has not been fully elucidated and requires additional research.
authors.affiliation: University of Michigan, Ann Arbor, Michigan, USA. mlapage@med.umich.edu
authors.forename: Martin J
authors.initials: MJ
authors.lastname: LaPage
authors.forename: John H
authors.initials: JH
authors.lastname: Reed
authors.forename: Kathryn K
authors.initials: KK
authors.lastname: Collins
authors.forename: Ian H
authors.initials: IH
authors.lastname: Law
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Pilcher
authors.forename: Ronn E
authors.initials: RE
authors.lastname: Tanel
authors.forename: Charles C
authors.initials: CC
authors.lastname: Anderson
authors.forename: Ming-Lon
authors.initials: ML
authors.lastname: Young
authors.forename: Mathias
authors.initials: M
authors.lastname: Emmel
authors.forename: Thomas
authors.initials: T
authors.lastname: Paul
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Blaufox
authors.forename: Gaurav
authors.initials: G
authors.lastname: Arora
authors.forename: J Philip
authors.initials: JP
authors.lastname: Saul
mesh_terms: D001145:Arrhythmias, Cardiac / Q000601:surgery*; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003452:Cryosurgery / Q000009:adverse effects*; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome