Volume 33, Issue 6 pp. 681-686

Cryoablation with an 8-mm Tip Catheter for Pediatric Atrioventricular Nodal Reentrant Tachycardia Is Safe and Efficacious with a Low Incidence of Recurrence

ERIC S. SILVER M.D.

ERIC S. SILVER M.D.

Morgan Stanley Children's Hospital of New York Presbyterian Hospital, Columbia University, New York, New York

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JENNIFER N. A. SILVA M.D.

JENNIFER N. A. SILVA M.D.

Washington University School of Medicine/St. Louis Children's Hospital, St. Louis, Missouri

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SCOTT R. CERESNAK M.D.

SCOTT R. CERESNAK M.D.

Lucile Packard Children's Hospital at Stanford University, Palo Alto, California

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NANCY A. CHIESA R.N.

NANCY A. CHIESA R.N.

University of California, San Francisco (UCSF), San Francisco, California

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EDWARD K. RHEE M.D.

EDWARD K. RHEE M.D.

Eller Congenital Heart Center, St. Joseph's Hospital and Medical Center, Phoenix, Arizona

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ANNE M. DUBIN M.D.

ANNE M. DUBIN M.D.

Lucile Packard Children's Hospital at Stanford University, Palo Alto, California

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KISHOR AVASARALA M.D.

KISHOR AVASARALA M.D.

University of California, San Francisco (UCSF), San Francisco, California

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GEORGE F. VAN HARE M.D.

GEORGE F. VAN HARE M.D.

Washington University School of Medicine/St. Louis Children's Hospital, St. Louis, Missouri

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KATHRYN K. COLLINS M.D.

KATHRYN K. COLLINS M.D.

University of Colorado, The Children's Hospital, Denver, Colorado

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First published: 02 June 2010
Citations: 46
Address for reprints: Eric S. Silver, M.D., Pediatric Arrhythmia Service, Division of Pediatric Cardiology, Morgan Stanley Children's Hospital of New York Presbyterian Hospital, Columbia University, 3959 Broadway Avenue, 2-North, New York, NY 10032. Fax: 212-342-5704; e-mail: [email protected]

The authors have no conflict of interest and there was no financial support for this study.

This submission is with the full knowledge and approval of the listed co-authors.

Abstract

Background: Cryoablation with 4- and 6-mm tip ablation catheters has been demonstrated to be safe and effective in the treatment of atrioventricular nodal reentrant tachycardia (AVNRT) in pediatric patients, albeit with a higher rate of clinical recurrence. Limited information is available regarding efficacy, mid-term outcomes, and complications related to the use of the 8-mm Freezor Max Cryoablation catheter (Medtronic, Minneapolis, MN, USA) in pediatric patients.

Methods: We performed a retrospective review of all pediatric patients with normal cardiac anatomy who underwent an ablation procedure for treatment of AVNRT using the 8-mm tip Cryoablation catheter at three large pediatric academic arrhythmia centers.

Results: Cryoablation with an 8-mm tip catheter was performed in 77 patients for treatment of AVNRT (female n = 40 [52%], age 14.8 ± 2.2 years, weight 62.0 ± 13.9 kg). Initial procedural success was achieved in 69 patients (69/76, 91%). Transient second- or third-degree atrioventricular (AV) block was noted in five patients (6.5%). There was no permanent AV block. Of the patients successfully ablated with Cryotherapy, there were two recurrences (2/70, 2.8%) over a follow-up of 11.6 ± 3.3 months.

Conclusion: Cryoablation with an 8-mm tip ablation catheter is both safe and effective with a low risk of recurrence for the treatment of AVNRT in pediatric patients. (PACE 2010; 33:681–686)

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