Cryoablation of right-sided accessory pathways in children: report of efficacy and safety after 10-year experience and follow-up.

Abstract

AIMS:

The aim of this study was to report the 10-year experience of our Institution in cryoablation of supraventricular tachycardia due to a right accessory pathway (AP).

METHODS AND RESULTS:

Seventy-one cryoablations of right AP were performed between July 2002 and October 2011 in our Institution in 66 patients (mean age 12 + 3 years, 56% males). Acute procedural success rate was 97%: 80% in patients with concealed AP and 100% in those with manifest AP (P < 0.05). Acute procedural success rate was not related to institutional experience. No permanent complication occurred. Sixteen patients had recurrences during the follow-up (18.6 ± 6.6 months; range 3-111), 13 within the first month of follow-up, 2 within the 6 months of follow-up, and 1 within 12 months of follow-up. Cox regression showed that sex, patient age, number of delivered cryo-bonus, and presence of manifest or concealed AP are not independent predictors of procedural success. Among the 16 patients with recurrences, in 10 a cryoablation redo was successful and with no further AP recurrences. The mean fluoroscopy time was 28.4 min (range 19.7-44.6) with a significant decrease (P = 0.033) in relation to the increase of the institutional experience. There were no permanent ablation-related complications.

CONCLUSION:

Cryoablation of right-sided AP is effective and very safe in children. Better results are achieved in manifest AP. The learning curve has a real impact in the attempt to reduce the fluoroscopy time.

• Authors: Fabrizio Drago, Daniela Righi, Silvia Placidi, Mario Salvatore Russo, Corrado Di Mambro, Massimo Stefano Silvetti, Monica Prosperi
• Journal: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology (Europace) Vol. 15 Issue 11 Pg. 1651-6 (Nov 2013) ISSN: 1532-2092 [Electronic] England
• PMID: 23673973 (Publication Type: Journal Article)

Topics

• Accessory Atrioventricular Bundle (physiopathology, surgery)
• Adolescent
• Child
• Child, Preschool
• Cryosurgery (adverse effects, methods)
• Female
• Fluoroscopy
• Follow-Up Studies
• Humans
• Learning Curve
• Longitudinal Studies
• Male
• Recurrence
• Regression Analysis
• Retrospective Studies
• Tachycardia, Supraventricular (physiopathology, surgery)
• Time Factors
• Treatment Outcome
• Young Adult