Radiofrequency catheter ablation of atrioventricular node reentrant tachycardia in children with limited fluoroscopy

Moshe Swissa, Einat Birk, Tamir Dagan, Sody Abby Naimer, Michal Fogelman, Tom Einbinder, Elchanan Bruckheimer, Rami Fogelman

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background Limited fluoroscopy cryo-ablation using a 3D electro-anatomical system (3DS) has been used for AVNRT in children. We aimed to facilitate a fluoroscopy limited approach of RF ablation of AVNRT in children. Methods A retrospective study was performed of procedure parameters in children undergoing RF ablation of AVNRT in 75 consecutive children (June 2011 to November 2013 — Group A) using standard fluoroscopy techniques compared to those of 64 consecutive children (December 2013 to May 2015 — Group B), using a fluoroscopy limited approach with 3DS. Results The acute success rate was 98.7% (74/75) and 98.4% (63/64) for groups A and B, respectively. The recurrence rate was 2.7% (2/74) and 0% (0/63) with a mean follow-up period of 45.5 ± 12.1 and 14.3 ± 6.1 months for group A and group B, respectively. The mean procedure and fluoroscopy times were significantly lower for group B compared to group A (119 ± 37 (43–203) and 0.83 ± 1.04 (0.05–3.83) minutes versus 146 ± 53 (72–250) and 16.1 ± 8.9 (4.39–55) minutes, p < 0.003 and p < 0.0001, respectively). There were no ablation-related complications. Conclusions A fluoroscopy limited approach for RF ablation of AVNRT in children using a 3DS is easily acquired and adapted, and significantly reduces the fluoroscopy and procedure time with excellent efficacy, safety and low recurrence rate. Condensed ABSTRACT This study confirmed that a 3D mapping system (3DS) to guide ablations of AVNRT in children reduces radiation exposure. Combined, limited fluoroscopy and 3DS in a methodology that resembles the familiar conventional fluoroscopy approach for RF ablation of AVNRT in children is proposed. Combined limited fluoroscopy and RF-energy in children with AVNRT are associated with a shorter procedure time, minimal fluoroscopy time, a high success rate and a low recurrence rate.

Original languageEnglish
Pages (from-to)198-202
Number of pages5
JournalInternational Journal of Cardiology
Volume236
DOIs
StatePublished - 1 Jun 2017

Keywords

  • Atrioventricular nodal reentrant tachycardia (AVNRT)
  • Catheter ablation
  • Electro-anatomic mapping systems
  • Limited fluoroscopy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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