Akademik Veri Yönetim Sistemi
AEPC 2022 - 55th Annual Meeting of the Association for European Paediatric and Congenital Cardiology , Geneve, İsviçre, 25 - 28 Mayıs 2022, ss.493-494
BACKGROUND AND AIM: The aim of this comperative study was to evaluate the mid-term efficacy of
8 mm tip cryoablation with /without low voltage mapping of Koch's triangle after first succesfull
crıyolesion during typical atrioventricular nodal reentrant tachycardia (tAVNRT) in children.
METHODS: From 2013 to December 2021, 204 pediatric patients who underwent cryoablation with 8
mm tip cryocatheter for tAVNRT in our center were included. EnSite™ (St. Jude Medical Inc., St. Paul,
MN, USA) was used in all patients. Standard electroanatomical approach without voltage mapping
was performed prior to October 2020 (Control group). In the voltage mapping group, Ensite system
was used to develop a “bridge” of lower voltage gradients(0.2-0.8 mV) of the inferoposteroseptal
right atrium to guide cryoablation. Patients who had congenital heart disease, other arrhythmia
substrates and prior ablation attempts with either RF or cryoablation were excluded. First
cryoablation lesion was applied during tachycardia in all patients.
RESULTS: 204 patients were included (58 low voltage,146 control). There was no difference between
groups with regard to age (13.86±2.78 vs 13.6±2.77; p: 0.559), gender (38 / 65.5% vs 79 / 54.1%; p:
0.159), or catheter-tip size (8 mm). Fluoroscopy was not used in any procedure. Total procedural
time was similar in voltage and control groups (135.8 ±30.2 min vs 138.68±33.61 min; p = 0.581).
Acute success was similar in both groups (100% Voltage vs 99% Control; P = 0. 0.991) The overall
recurrence rate were similar (1, [1.7%] and 2, [1.4%]; p:0.380) Follow-up time was shorter in the
Voltage group (5.98 ± 3.66 months vs 42.3 ±18.01; p:0.001) There was no major or minor
complications were reported during or after the procedures in either group.
CONCLUSIONS: Use of a slow pathway voltage map in Koch’s triangle with 8 mm tip criyo ablation
catheter is a safe and effective method in children with tAVNRT. Although there is no significant
difference between both groups in acute success rate, procedure duration, cryolesion number, and
recurrence rate, a longer follow-up period is needed to evaluate the long-term results.