title: Comparison of cryoablation with 3D mapping versus conventional mapping for the treatment of atrioventricular re-entrant tachycardia and right-sided paraseptal accessory pathways.
abstract: Aim Transcatheter cryoablation is a well-established technique for the treatment of atrioventricular nodal re-entry tachycardia and atrioventricular re-entry tachycardia in children. Fluoroscopy or three-dimensional mapping systems can be used to perform the ablation procedure. The aim of this study was to compare the success rate of cryoablation procedures for the treatment of right septal accessory pathways and atrioventricular nodal re-entry circuits in children using conventional or three-dimensional mapping and to evaluate whether three-dimensional mapping was associated with reduced patient radiation dose compared with traditional mapping.
  
  
  METHODS
  In 2013, 81 children underwent transcatheter cryoablation at our institution, using conventional mapping in 41 children - 32 atrioventricular nodal re-entry tachycardia and nine atrioventricular re-entry tachycardia - and three-dimensional mapping in 40 children - 24 atrioventricular nodal re-entry tachycardia and 16 atrioventricular re-entry tachycardia.
  
  
  RESULTS
  Using conventional mapping, the overall success rate was 78.1 and 66.7% in patients with atrioventricular nodal re-entry tachycardia or atrioventricular re-entry tachycardia, respectively. Using three-dimensional mapping, the overall success rate was 91.6 and 75%, respectively (p=ns). The use of three-dimensional mapping was associated with a reduction in cumulative air kerma and cumulative air kerma-area product of 76.4 and 67.3%, respectively (p<0.05).
  
  
  CONCLUSIONS
  The use of three-dimensional mapping compared with the conventional fluoroscopy-guided method for cryoablation of right septal accessory pathways and atrioventricular nodal re-entry circuits in children was associated with a significant reduction in patient radiation dose without an increase in success rate.
authors.affiliation: 1Paediatric Cardiac Arrhythmias Complex Unit and Syncope Unit,Bambino Gesù Children's Hospital and Research Institute,Palidoro-Fiumicino,Rome,Italy.
authors.forename: Mario S
authors.initials: MS
authors.lastname: Russo
authors.affiliation: 1Paediatric Cardiac Arrhythmias Complex Unit and Syncope Unit,Bambino Gesù Children's Hospital and Research Institute,Palidoro-Fiumicino,Rome,Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Drago
authors.affiliation: 1Paediatric Cardiac Arrhythmias Complex Unit and Syncope Unit,Bambino Gesù Children's Hospital and Research Institute,Palidoro-Fiumicino,Rome,Italy.
authors.forename: Massimo S
authors.initials: MS
authors.lastname: Silvetti
authors.affiliation: 1Paediatric Cardiac Arrhythmias Complex Unit and Syncope Unit,Bambino Gesù Children's Hospital and Research Institute,Palidoro-Fiumicino,Rome,Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Righi
authors.affiliation: 1Paediatric Cardiac Arrhythmias Complex Unit and Syncope Unit,Bambino Gesù Children's Hospital and Research Institute,Palidoro-Fiumicino,Rome,Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Di Mambro
authors.affiliation: 1Paediatric Cardiac Arrhythmias Complex Unit and Syncope Unit,Bambino Gesù Children's Hospital and Research Institute,Palidoro-Fiumicino,Rome,Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Placidi
authors.affiliation: 1Paediatric Cardiac Arrhythmias Complex Unit and Syncope Unit,Bambino Gesù Children's Hospital and Research Institute,Palidoro-Fiumicino,Rome,Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Prosperi
authors.affiliation: 2St. Jude Medical,Agrate Brianza,Rome,Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Ciani
authors.affiliation: 3Freelancer,Rome,Italy.
authors.forename: Maria T
authors.initials: MT
authors.lastname: Naso Onofrio
authors.affiliation: 4Enterprise Risk Management,Bambino Gesù Children's Hospital and Research Institute,Rome,Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Cannatà
mesh_terms: D058606:Accessory Atrioventricular Bundle / Q000000981:diagnostic imaging* / Q000601:surgery; D000293:Adolescent; D001283:Atrioventricular Node / Q000000981:diagnostic imaging* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D012044:Regression Analysis; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000000981:diagnostic imaging* / Q000601:surgery; D013617:Tachycardia, Supraventricular / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome
keywords: Supraventricular tachycardia; children; cryoablation; three-dimensional mapping