Comparison of cryoablation with 3D mapping versus conventional mapping for the treatment of atrioventricular re-entrant tachycardia and right-sided paraseptal accessory pathways

Mario Salvatore Russo, Fabrizio Drago, Massimo S Silvetti, Daniela Righi, Corrado Di Mambro, Silvia Placidi, Monica Prosperi, Michele Ciani, Maria Teresa Naso Onofrio, Vittorio Cannatà

Research output: Contribution to journalArticle

Abstract

UNLABELLED: 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.

Original languageEnglish
Pages (from-to)931-40
Number of pages10
JournalCardiology in the Young
Volume26
Issue number5
DOIs
Publication statusPublished - Jun 2016

Keywords

  • Accessory Atrioventricular Bundle
  • Adolescent
  • Atrioventricular Node
  • Child
  • Child, Preschool
  • Cryosurgery
  • Female
  • Fluoroscopy
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Regression Analysis
  • Tachycardia, Atrioventricular Nodal Reentry
  • Tachycardia, Supraventricular
  • Treatment Outcome
  • Comparative Study
  • Journal Article

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