RESUMO
Due to its safety profile, cryoablation (Cryo) for atrioventricular nodal reentrant tachycardia (AVNRT) is more commonly preferred over radiofrequency (RF) ablation in children in recent years. Recent studies demonstrated high long-term success rates comparable to radiofrequency ablation. The aim of this prospective study was to compare the efficacy and safety of an 8-mm-tip versus 6-mm-tip Cryo catheter in the treatment of AVNRT in children. A total of 125 consecutive patients over 10 years of age with AVNRT were included. EnSite system (St. JudeMedical, St Paul, MN, USA) was used to reduce or eliminate fluoroscopy. The acute procedural success was 100% in both groups. The prodecure duration for the 8-mm-tip group was shorter (151.6 ± 63.2 vs. 126.6 ± 36.7 min, p < 0.01, respectively). Fluoroscopy was used in only 7 patients. The mean follow-up duration was 14.6 ± 8.4 months (median 13.5 months, min. 3 months and max. 27 months). The recurrence rate for AVNRT was also comparable between the two groups (6-mm tip: 9.6 vs. 8-mm tip: 8%). Cryo of AVNRT is a safe and effective procedure with comparable acute and mid-term follow-up success rates using 6-mm and 8-mm-tip catheters in children. In addition, procedure duration is shorter with an 8-mm-tip Cryo catheter.
Assuntos
Cateterismo Cardíaco/instrumentação , Cateteres Cardíacos , Criocirurgia/instrumentação , Taquicardia por Reentrada no Nó Atrioventricular/cirurgia , Adolescente , Criança , Técnicas Eletrofisiológicas Cardíacas , Feminino , Cardiopatias Congênitas/complicações , Humanos , Masculino , Estudos Prospectivos , Estudos Retrospectivos , Taquicardia por Reentrada no Nó Atrioventricular/complicações , Taquicardia por Reentrada no Nó Atrioventricular/diagnósticoRESUMO
We report the case of a 14-year-old boy patient admitted to our outpatient clinic with palpitations and documented supraventricular tachycardia. Electrophysiological study and ablation were planned. In the electrophysiological study, two tachycardias with different cycle lengths and morphologies were induced. After elimination of the slow pathway, left posterior accessory pathway was detected and successfully ablated. Another pathway was detected following that ablation. Due to the slow retrograde conduction of this pathway, diltiazem infusion was started to uncover the accessory pathway. The second accessory pathway was at the left posteroseptal region and was successfully ablated. After a 30-minute waiting period, no tachycardia was induced. In addition, no fluoroscopy was used during the procedure.