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Erschienen in: Pediatric Cardiology 6/2017

13.06.2017 | Original Article

Comparison of 6-mm Versus 8-mm-Tip Cryoablation Catheter for the Treatment of Atrioventricular Nodal Reentrant Tachycardia in Children: A Prospective Study

verfasst von: Volkan Tuzcu, Enes Elvin Gul, Mehmet Karacan, Hacer Kamali, Nida Celik, Celal Akdeniz

Erschienen in: Pediatric Cardiology | Ausgabe 6/2017

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Abstract

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.
Literatur
1.
Zurück zum Zitat Van Hare GF, Javitz H, Carmelli D, Saul JP, Tanel RE, Fischbach PS, Kantel RJ et al (2004) Prospective assessment after pediatric cardiac ablation: demographics, medical profiles, and initial outcomes. J Cardiovasc Electrophysiol 15(7):759–770CrossRefPubMed Van Hare GF, Javitz H, Carmelli D, Saul JP, Tanel RE, Fischbach PS, Kantel RJ et al (2004) Prospective assessment after pediatric cardiac ablation: demographics, medical profiles, and initial outcomes. J Cardiovasc Electrophysiol 15(7):759–770CrossRefPubMed
2.
Zurück zum Zitat Hindricks G (1993) The Multicentre European Radiofrequency Survey (MERFS): complications of radiofrequency catheter ablation of arrhythmias. The Multicentre European Radiofrequency Survey (MERFS) investigators of the Working Group on Arrhythmias of the European Society of Cardiology. Eur Heart J 14(12):1644–1653CrossRefPubMed Hindricks G (1993) The Multicentre European Radiofrequency Survey (MERFS): complications of radiofrequency catheter ablation of arrhythmias. The Multicentre European Radiofrequency Survey (MERFS) investigators of the Working Group on Arrhythmias of the European Society of Cardiology. Eur Heart J 14(12):1644–1653CrossRefPubMed
3.
Zurück zum Zitat de Sisti A, Tonet J (2012) Cryoablation of atrioventricular nodal reentrant tachycardia: a clinical review. Pacing Clin Electrophysiol 35(2):233–240CrossRefPubMed de Sisti A, Tonet J (2012) Cryoablation of atrioventricular nodal reentrant tachycardia: a clinical review. Pacing Clin Electrophysiol 35(2):233–240CrossRefPubMed
4.
Zurück zum Zitat Deisenhofer I, Zrenner B, Yin YH, Pitschner HF, Kuniss M, Grossmann G, Stiller S et al (2010) Cryoablation versus radiofrequency energy for the ablation of atrioventricular nodal reentrant tachycardia (the CYRANO Study): results from a large multicenter prospective randomized trial. Circulation 122(22):2239–2245CrossRefPubMed Deisenhofer I, Zrenner B, Yin YH, Pitschner HF, Kuniss M, Grossmann G, Stiller S et al (2010) Cryoablation versus radiofrequency energy for the ablation of atrioventricular nodal reentrant tachycardia (the CYRANO Study): results from a large multicenter prospective randomized trial. Circulation 122(22):2239–2245CrossRefPubMed
5.
Zurück zum Zitat Collins KK, Dubin AM, Chiesa NA, Avasarala K, Van Hare GF (2006) Cryoablation versus radiofrequency ablation for treatment of pediatric atrioventricular nodal reentrant tachycardia: initial experience with 4-mm cryocatheter. Heart Rhythm 3(5):564–570CrossRefPubMed Collins KK, Dubin AM, Chiesa NA, Avasarala K, Van Hare GF (2006) Cryoablation versus radiofrequency ablation for treatment of pediatric atrioventricular nodal reentrant tachycardia: initial experience with 4-mm cryocatheter. Heart Rhythm 3(5):564–570CrossRefPubMed
6.
Zurück zum Zitat Chan NY, Mok NS, Lau CL, Lo YK, Choy CC, Lau ST, Choi YC (2009) Treatment of atrioventricular nodal re-entrant tachycardia by cryoablation with a 6 mm-tip catheter vs. radiofrequency ablation. Europace 11(8):1065–1070CrossRefPubMed Chan NY, Mok NS, Lau CL, Lo YK, Choy CC, Lau ST, Choi YC (2009) Treatment of atrioventricular nodal re-entrant tachycardia by cryoablation with a 6 mm-tip catheter vs. radiofrequency ablation. Europace 11(8):1065–1070CrossRefPubMed
7.
Zurück zum Zitat Chan NY, Choy CC, Lau CL, Lo YK, Chu PS, Yuen HC et al (2011) Cryoablation versus radiofrequency ablation for atrioventricular nodal reentrant tachycardia: patient pain perception and operator stress. Pacing Clin Electrophysiol 34(1):2–7CrossRefPubMed Chan NY, Choy CC, Lau CL, Lo YK, Chu PS, Yuen HC et al (2011) Cryoablation versus radiofrequency ablation for atrioventricular nodal reentrant tachycardia: patient pain perception and operator stress. Pacing Clin Electrophysiol 34(1):2–7CrossRefPubMed
8.
Zurück zum Zitat Chan NY, Mok NS, Choy CC, Lau CL, Chu PS, Yuen HC, Lau ST (2012) Treatment of atrioventricular nodal re-entrant tachycardia by cryoablation with an 8-mm-tip catheter versus radiofrequency ablation. J Interv Card Electrophysiol 34(3):295–301CrossRefPubMed Chan NY, Mok NS, Choy CC, Lau CL, Chu PS, Yuen HC, Lau ST (2012) Treatment of atrioventricular nodal re-entrant tachycardia by cryoablation with an 8-mm-tip catheter versus radiofrequency ablation. J Interv Card Electrophysiol 34(3):295–301CrossRefPubMed
9.
Zurück zum Zitat Kimman GP, Theuns DA, Szili-Torok T, Scholten MF, Res JC, Jordaens LJ (2004) CRAVT: a prospective, randomized study comparing transvenous cryothermal and radiofrequency ablation in atrioventricular nodal re-entrant tachycardia. Eur Heart J 25(24):2232–2237CrossRefPubMed Kimman GP, Theuns DA, Szili-Torok T, Scholten MF, Res JC, Jordaens LJ (2004) CRAVT: a prospective, randomized study comparing transvenous cryothermal and radiofrequency ablation in atrioventricular nodal re-entrant tachycardia. Eur Heart J 25(24):2232–2237CrossRefPubMed
10.
Zurück zum Zitat Hanninen M, Yeung-Lai-Wah N, Massel D, Gula LJ, Skanes AC, Yee R, Klein GJ et al (2013) Cryoablation versus RF ablation for AVNRT: A meta-analysis and systematic review. J Cardiovasc Electrophysiol 24:1354–1360CrossRefPubMed Hanninen M, Yeung-Lai-Wah N, Massel D, Gula LJ, Skanes AC, Yee R, Klein GJ et al (2013) Cryoablation versus RF ablation for AVNRT: A meta-analysis and systematic review. J Cardiovasc Electrophysiol 24:1354–1360CrossRefPubMed
11.
Zurück zum Zitat Das S, Law IH, Von Bergen NH, Bradley DJ, Dick M 2nd, Etheridge SP, Saarel EV et al (2012) Cryoablation therapy for atrioventricular nodal reentrant tachycardia in children: a multicenter experience of efficacy. Pediatr Cardiol 33(7):1147–1153CrossRefPubMed Das S, Law IH, Von Bergen NH, Bradley DJ, Dick M 2nd, Etheridge SP, Saarel EV et al (2012) Cryoablation therapy for atrioventricular nodal reentrant tachycardia in children: a multicenter experience of efficacy. Pediatr Cardiol 33(7):1147–1153CrossRefPubMed
12.
Zurück zum Zitat Khairy P, Rivard L, Guerra PG, Tanguay JF, Mawad W, Roy D, Talajic M et al (2008) Morphometric ablation lesion characteristics comparing 4, 6, and 8 mm electrode-tip cryocatheters. J Cardiovasc Electrophysiol 19(11):1203–1207CrossRefPubMed Khairy P, Rivard L, Guerra PG, Tanguay JF, Mawad W, Roy D, Talajic M et al (2008) Morphometric ablation lesion characteristics comparing 4, 6, and 8 mm electrode-tip cryocatheters. J Cardiovasc Electrophysiol 19(11):1203–1207CrossRefPubMed
13.
Zurück zum Zitat Silver ES, Silva JN, Ceresnak SR, Chiesa NA, Rhee EK, Dubin AM, Avasarala K et al (2010) Cryoablation with an 8-mm tip catheter for pediatric atrioventricular nodal reentrant tachycardia is safe and efficacious with a low incidence of recurrence. Pacing Clin Electrophysiol 33(6):681–686CrossRefPubMed Silver ES, Silva JN, Ceresnak SR, Chiesa NA, Rhee EK, Dubin AM, Avasarala K et al (2010) Cryoablation with an 8-mm tip catheter for pediatric atrioventricular nodal reentrant tachycardia is safe and efficacious with a low incidence of recurrence. Pacing Clin Electrophysiol 33(6):681–686CrossRefPubMed
14.
Zurück zum Zitat Peyrol M, Sbragia P, Uhry S, Boccara G, Dolla E, Quatre A, Guenoun M et al (2013) Slow pathway elimination for atrioventricular nodal reentrant tachycardia with the 8-mm tip cryoablation catheter: an 18-month follow-up study. J Interv Card Electrophysiol 37(1):105–109CrossRefPubMed Peyrol M, Sbragia P, Uhry S, Boccara G, Dolla E, Quatre A, Guenoun M et al (2013) Slow pathway elimination for atrioventricular nodal reentrant tachycardia with the 8-mm tip cryoablation catheter: an 18-month follow-up study. J Interv Card Electrophysiol 37(1):105–109CrossRefPubMed
15.
Zurück zum Zitat LaPage MJ, Saul JP, Reed JH (2010) Long-term outcomes for cryoablation of pediatric patients with atrioventricular nodal reentrant tachycardia. Am J Cardiol 105(8):1118–1121CrossRefPubMed LaPage MJ, Saul JP, Reed JH (2010) Long-term outcomes for cryoablation of pediatric patients with atrioventricular nodal reentrant tachycardia. Am J Cardiol 105(8):1118–1121CrossRefPubMed
16.
Zurück zum Zitat Cokkinakis C, Avramidis D, Alexopoulos C, Kirvassilis G, Papagiannis J (2013) Cryoablation of AVNRT in children and adolescents: improved long-term outcomes with increasing experience. Hellenic J Cardiol 54:186–191PubMed Cokkinakis C, Avramidis D, Alexopoulos C, Kirvassilis G, Papagiannis J (2013) Cryoablation of AVNRT in children and adolescents: improved long-term outcomes with increasing experience. Hellenic J Cardiol 54:186–191PubMed
17.
Zurück zum Zitat Drago F, Silvetti MS, De Santis A, Grutter G, Andrew P (2006) Lengthier cryoablation and a bonus cryoapplication is associated with improved efficacy for cryothermal catheter ablation of supraventricular tachycardias in children. J Interv Card Electrophysiol 16(3):191–198CrossRefPubMed Drago F, Silvetti MS, De Santis A, Grutter G, Andrew P (2006) Lengthier cryoablation and a bonus cryoapplication is associated with improved efficacy for cryothermal catheter ablation of supraventricular tachycardias in children. J Interv Card Electrophysiol 16(3):191–198CrossRefPubMed
18.
Zurück zum Zitat Schneider HE, Stahl M, Kriebel T, Schillinger W, Schill M, Jakobi J, Paul T (2012) Double Cryoenergy Application (Freeze-Thaw-Freeze) at Growing Myocardium: lesion volume and effects on coronary arteries early after energy application. Implications for efficacy and safety in pediatric patients. J Cardiovasc Electrophysiol 24:701–707CrossRef Schneider HE, Stahl M, Kriebel T, Schillinger W, Schill M, Jakobi J, Paul T (2012) Double Cryoenergy Application (Freeze-Thaw-Freeze) at Growing Myocardium: lesion volume and effects on coronary arteries early after energy application. Implications for efficacy and safety in pediatric patients. J Cardiovasc Electrophysiol 24:701–707CrossRef
19.
Zurück zum Zitat Czosek RJ, Anderson J, Marino BS, Connor C, Knilans TK (2010) Linear lesion cryoablation for the treatment of atrioventricular nodal re-entry tachycardia in pediatrics and young adults. Pacing Clin Electrophysiol 33:1304–1311CrossRefPubMed Czosek RJ, Anderson J, Marino BS, Connor C, Knilans TK (2010) Linear lesion cryoablation for the treatment of atrioventricular nodal re-entry tachycardia in pediatrics and young adults. Pacing Clin Electrophysiol 33:1304–1311CrossRefPubMed
20.
Zurück zum Zitat Tuzcu V (2012) Significant reduction of fluoroscopy in pediatric catheter ablation procedures: long-term experience from a single center. Pacing Clin Electrophysiol 35:1067–1073CrossRefPubMed Tuzcu V (2012) Significant reduction of fluoroscopy in pediatric catheter ablation procedures: long-term experience from a single center. Pacing Clin Electrophysiol 35:1067–1073CrossRefPubMed
21.
Zurück zum Zitat Smith G, Clark JM (2007) Elimination of fluoroscopy use in a pediatric electrophysiology laboratory using three-dimensional mapping. Pacing Clin Electrophysiol 30:510–518CrossRefPubMed Smith G, Clark JM (2007) Elimination of fluoroscopy use in a pediatric electrophysiology laboratory using three-dimensional mapping. Pacing Clin Electrophysiol 30:510–518CrossRefPubMed
22.
Zurück zum Zitat Scaglione M, Ebrille E, Caponi D, Blandino A, DI Donna P, Siboldi A, Bertero G et al (2013) Single center experience of fluoroless AVNRT ablation guided by Electroanatomical Reconstruction in children and adolescents. Pacing Clin Electrophysiol 36:1460–1467CrossRefPubMed Scaglione M, Ebrille E, Caponi D, Blandino A, DI Donna P, Siboldi A, Bertero G et al (2013) Single center experience of fluoroless AVNRT ablation guided by Electroanatomical Reconstruction in children and adolescents. Pacing Clin Electrophysiol 36:1460–1467CrossRefPubMed
23.
Zurück zum Zitat Casella M, Dello Russo A, Pelargonio G, Del Greco M, Zingarini G, Piacenti M et al (2016) Near zerO fluoroscopic exPosure during catheter ablAtion of supRavenTricular arrhYthmias: the NO-PARTY multicentre randomized trial. Europace 18:1565–1572CrossRefPubMed Casella M, Dello Russo A, Pelargonio G, Del Greco M, Zingarini G, Piacenti M et al (2016) Near zerO fluoroscopic exPosure during catheter ablAtion of supRavenTricular arrhYthmias: the NO-PARTY multicentre randomized trial. Europace 18:1565–1572CrossRefPubMed
Metadaten
Titel
Comparison of 6-mm Versus 8-mm-Tip Cryoablation Catheter for the Treatment of Atrioventricular Nodal Reentrant Tachycardia in Children: A Prospective Study
verfasst von
Volkan Tuzcu
Enes Elvin Gul
Mehmet Karacan
Hacer Kamali
Nida Celik
Celal Akdeniz
Publikationsdatum
13.06.2017
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 6/2017
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-017-1648-z

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