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Pacing Clin Electrophysiol. 2013 Mar;36(3):279-85. doi: 10.1111/j.1540-8159.2012.03514.x. Epub 2012 Sep 14.

Low recurrence rate in treating atrioventricular nodal reentrant tachycardia with triple freeze-thaw cycles.

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  • 1Department of Pediatrics, Division of Pediatric Cardiology, University of Miami, Miami, Florida.

Abstract

BACKGROUND:

Cryoablation is an alternative to radiofrequency ablation in treating atrioventricular nodal reentrant tachycardia (AVNRT). However, its long-term effectiveness is in question when compared to radiofrequency ablation. We reviewed the results of cryoablation in children with AVNRT at our institute.

METHODS:

We performed a retrospective single-center chart review of consecutive patients ≤18 years of age with AVNRT who underwent cryoablation between January 2007 and August 2009. During cryoablation, a 6-mm-tip cryocatheter was used with temperature set to -80°C. Test lesions were performed at the presumed slow pathway location based on combined anatomic and electrophysiologic approach. If successful, ablation was then continued with triple freeze-thaw cycles (FTC) of 4 minutes each.

RESULTS:

A total of 53 patients (age range: 6.1-18.4 years, mean: 13.6 years, median: 13.2 years) underwent slow pathway modification with cryoablation. Acute success was achieved in 51 (96.2%) cases. Transient atrioventricular block was seen in 19 cases. The block occurred during FTC in eight patients (15%). The number of FTC was three in 47 (92.2%) patients. Less than three FTC were given in two patients due to transient heart block and four FTC were given in two patients with suspected catheter movement. Procedure duration was 177 ± 56 minutes; fluoroscopic time was 14 ± 11 minutes. Mean follow-up was 30.7 ± 10 (range 12-52, median 31) months. Recurrence of supraventricular tachycardia was seen in only one (1.96%) patient.

CONCLUSIONS:

Triple FTC cryoablation lesions resulted in a low recurrence rate comparable to RF ablation in treating AVNRT without increased complications.

©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.

[PubMed - indexed for MEDLINE]
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