Transcatheter ablation of atrioventricular junctional re-entrant tachycardia in children and adolescents in Hong Kong: comparison of cryothermal with radiofrequency energy.
OBJECTIVE
To compare the outcome of cryothermal and radiofrequency energy transcatheter ablation of atrioventricular junctional re-entrant tachycardia in children and adolescents.


METHODS
Case series with internal comparison.


METHODS
Two hospitals in Hong Kong.


METHODS
Consecutive transcatheter ablation procedures for atrioventricular junctional re-entrant tachycardia in children and adolescents in our unit from August 2000 to September 2008 were retrospectively reviewed. Radiofrequency ablation was performed from August 2000 to June 2005, and cryoablation from July 2005 to September 2008.


METHODS
Demographic data, outcome and procedural details.


RESULTS
Thirty-eight procedures were reviewed. The radiofrequency ablation group (n=20) and cryoablation group (n=18) had similar demographic characteristics, except that there were more patients with congenital heart disease in the latter group (P=0.03). Acute procedural success rate was 100% in both groups. One patient from the radiofrequency ablation group had recurrence of atrioventricular junctional re-entrant tachycardia. The frequency of post-ablation persistent heart block was higher in the radiofrequency ablation than cryoablation group (10% vs 0%, P=0.17), but this difference was not statistically significant. A shorter fluoroscopy time was noted in the cryoablation group (31 ± 13 vs 38 ± 18 minutes; P=0.03).


CONCLUSIONS
Transcatheter cryoablation for atrioventricular junctional re-entrant tachycardia in children and adolescents is as effective as radiofrequency ablation over the medium term. It has an excellent safety profile in terms of avoiding heart block.
Department of Paediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong. robin.hs.chen@gmail.com
Robin H S
RH
Chen
K T
KT
Wong
K S
KS
Lun
T C
TC
Yung
D000293:Adolescent; D001145:Arrhythmias, Cardiac / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D002648:Child; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000601:surgery*; D016896:Treatment Outcome