title: Cryoablation with an 8-mm-Tip Catheter for Right-Sided Accessory Pathways in Children.
abstract: BACKGROUND
  Cryoablation is increasingly utilized in children because of its safety profile. Recently, larger catheter tips have been more widely used to improve long-term success rates. The aim of this study was to assess the safety and efficacy of 8-mm-tip catheters for cryoablation of right-sided accessory pathways (APs) in children.
  
  
  METHODS
  Electrophysiological procedures were performed using the EnSite™ system (St. Jude Medical Inc., St. Paul, MN, USA).
  
  
  RESULTS
  Between July 2010 and July 2014, 54 patients (mean age: 13.1 ± 3.7 years) underwent cryoablation using an 8-mm-tip catheter. In 18 of 54 (33%) patients where an 8-mm-tip catheter was the first-choice catheter, the success rate was 18 of 18 (100%). There was a history of previous failed attempts or recurrence with radiofrequency ablation and/or 6-mm-tip cryoablation in 36 of 54 (67%) patients. The success rate in these patients was 24 of 36 (67%). No fluoroscopy was used in 34 of 54 procedures. The recurrence rate was six of 42 (14%) during a mean follow-up period of 32 ± 15 months. In one patient, transient atrioventricular block occurred.
  
  
  CONCLUSIONS
  Cryoablation with an 8-mm-tip catheter for right-sided APs in children who weigh over 40 kg appears to be safe and acutely effective in cases where conventional ablation methods fail and also as a first choice for ablation procedure. However, the recurrence rate still seems to be high.
authors.affiliation: Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, Istanbul, Turkey.
authors.forename: Ibrahim Cansaran
authors.initials: IC
authors.lastname: Tanidir
authors.affiliation: Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, Istanbul, Turkey.
authors.forename: Yakup
authors.initials: Y
authors.lastname: Ergul
authors.affiliation: Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, Istanbul, Turkey.
authors.forename: Erkut
authors.initials: E
authors.lastname: Ozturk
authors.affiliation: Department of Pediatric Cardiology and Electrophysiology, Istanbul Medipol University Hospital, Istanbul, Turkey.
authors.forename: Fuheda
authors.initials: F
authors.lastname: Dalgic
authors.affiliation: Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, Istanbul, Turkey.
authors.forename: Neslihan
authors.initials: N
authors.lastname: Kiplapinar
authors.affiliation: Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center and Research Hospital, Istanbul, Turkey.
authors.forename: Hasan Tahsin
authors.initials: HT
authors.lastname: Tola
authors.affiliation: Department of Pediatric Cardiology and Electrophysiology, Istanbul Medipol University Hospital, Istanbul, Turkey.
authors.forename: Celal
authors.initials: C
authors.lastname: Akdeniz
authors.affiliation: Department of Pediatric Cardiology and Electrophysiology, Istanbul Medipol University Hospital, Istanbul, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Tuzcu
mesh_terms: D058606:Accessory Atrioventricular Bundle / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D000293:Adolescent; D062906:Cardiac Catheters / Q000706:statistics & numerical data*; D015984:Causality; D003452:Cryosurgery / Q000295:instrumentation* / Q000706:statistics & numerical data*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
keywords: accessory pathway; atrioventricular reentrant tachycardia; catheter ablation; children; cryoablation