title: Radiofrequency catheter ablation of atrioventricular node reentrant tachycardia in children with limited fluoroscopy.
abstract: BACKGROUND
  Limited fluoroscopy cryo-ablation using a 3D electro-anatomical system (3DS) has been used for AVNRT in children. We aimed to facilitate a fluoroscopy limited approach of RF ablation of AVNRT in children.
  
  
  METHODS
  A retrospective study was performed of procedure parameters in children undergoing RF ablation of AVNRT in 75 consecutive children (June 2011 to November 2013 - Group A) using standard fluoroscopy techniques compared to those of 64 consecutive children (December 2013 to May 2015 - Group B), using a fluoroscopy limited approach with 3DS.
  
  
  RESULTS
  The acute success rate was 98.7% (74/75) and 98.4% (63/64) for groups A and B, respectively. The recurrence rate was 2.7% (2/74) and 0% (0/63) with a mean follow-up period of 45.5±12.1 and 14.3±6.1months for group A and group B, respectively. The mean procedure and fluoroscopy times were significantly lower for group B compared to group A (119±37 (43-203) and 0.83±1.04 (0.05-3.83) minutes versus 146±53 (72-250) and 16.1±8.9 (4.39-55) minutes, p<0.003 and p<0.0001, respectively). There were no ablation-related complications.
  
  
  CONCLUSIONS
  A fluoroscopy limited approach for RF ablation of AVNRT in children using a 3DS is easily acquired and adapted, and significantly reduces the fluoroscopy and procedure time with excellent efficacy, safety and low recurrence rate.
  
  
  CONCLUSIONS
  This study confirmed that a 3D mapping system (3DS) to guide ablations of AVNRT in children reduces radiation exposure. Combined, limited fluoroscopy and 3DS in a methodology that resembles the familiar conventional fluoroscopy approach for RF ablation of AVNRT in children is proposed. Combined limited fluoroscopy and RF-energy in children with AVNRT are associated with a shorter procedure time, minimal fluoroscopy time, a high success rate and a low recurrence rate.
authors.affiliation: Kaplan Medical Center, Rehovot, Israel; The Hebrew University, Jerusalem, Israel. Electronic address: swissam@mail.huji.ac.il.
authors.forename: Moshe
authors.initials: M
authors.lastname: Swissa
authors.affiliation: Schneider Children's Medical Center Israel, Petach Tikva, and Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Einat
authors.initials: E
authors.lastname: Birk
authors.affiliation: Schneider Children's Medical Center Israel, Petach Tikva, and Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Tamir
authors.initials: T
authors.lastname: Dagan
authors.affiliation: Department of Family Medicine, Siaal Family Medicine and Primary Care Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Sody Abby
authors.initials: SA
authors.lastname: Naimer
authors.affiliation: Schneider Children's Medical Center Israel, Petach Tikva, and Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Fogelman
authors.affiliation: Schneider Children's Medical Center Israel, Petach Tikva, and Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Tom
authors.initials: T
authors.lastname: Einbinder
authors.affiliation: Schneider Children's Medical Center Israel, Petach Tikva, and Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Elchanan
authors.initials: E
authors.lastname: Bruckheimer
authors.affiliation: Schneider Children's Medical Center Israel, Petach Tikva, and Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Rami
authors.initials: R
authors.lastname: Fogelman
mesh_terms: D000293:Adolescent; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*
keywords: Atrioventricular nodal reentrant tachycardia (AVNRT); Catheter ablation; Electro-anatomic mapping systems; Limited fluoroscopy