Transitioning from Radiofrequency Ablation to Cryoablation for Treatment of Pediatric Atrioventricular Nodal Reentrant Tachycardia: A Single Tertiary Center Experience.

Abstract

Catheter ablation of the slow pathway is the recommended treatment for atrioventricular nodal reentrant tachycardia (AVNRT) in children. Both radiofrequency ablation (RF) and cryoablation (CA) have been used for this purpose. In this report, we describe our experience during the transition period from RF to CA for the treatment of pediatric AVNRT. Between January 2012 and August 2021, a retrospective evaluation was conducted of the clinical features, procedural outcomes, and follow-ups of pediatric AVNRT patients who underwent catheter ablation at a pediatric electrophysiology center. The catheter ablation outcomes of 89 pediatric AVNRT patients were evaluated: 29 patients were ablated using RF (RF group) and 60 patients were ablated using CA (CA group). No significant difference was found between the groups in terms of gender, age, weight, and success and recurrence rates. The procedure duration and total lesion numbers were statistically significantly lower in the RF group compared with the CA group (86.67 ± 45.8 and 156.1 ± 37.7min; p = 0.01, 4 [3-6] and p < 0.01, 8 [7-9] lesions, respectively). Catheter ablation was successful in all patients. There were no permanent complete atrioventricular blocks in both groups. A total of six patients (6.8%) developed recurrences. The cryoablation of pediatric AVNRT is a safe and effective procedure with comparable acute and mid-term follow-up success rates compared with RF, even during a period of transition from RF to CA.