Trans-jugular approach for safe and successful cryoablation of para-Hisian/anterior-septal, anterior, and anterior-lateral accessory pathways in children.

Autor: Drago F; Paediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy. fabrizio.drago@opbg.net., Flore F; Paediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy., Tamborrino PP; Paediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy., Silvetti MS; Paediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy., Maiolo S; Paediatric Cardiology and Cardiac Arrhythmias Complex Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy., Raponi M; Medical Directorate, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
Jazyk: angličtina
Zdroj: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing [J Interv Card Electrophysiol] 2024 Apr 20. Date of Electronic Publication: 2024 Apr 20.
DOI: 10.1007/s10840-024-01807-w
Abstrakt: Background: Cryoablation of APs localized near the atrioventricular (AV) junction is a well-established ablation strategy in children, and it has proved to be very safe. However, recurrence rates remain considerable for specific accessory pathway (AP) localizations. The aim of this retrospective study was to evaluate the efficacy and safety of a trans-jugular approach for cryoablation of right anterior, anterior-lateral, and anterior-septal APs in children, as compared to the conventional femoral approach.
Methods: From June 2019 to November 2023, 24 consecutive patients (mean age 13.2 ± 4.6, 12 males (50% of total cohort)) with right anterior-lateral, anterior, and anterior-septal/para-Hisian APs underwent 3D non-fluoroscopic transcatheter cryoablation through the right jugular vein at our Institution. Ablation results were compared with 24 patients for whom a conventional trans-femoral approach was used.
Results: Acute procedural success rate was 100% (n = 24/24), with a non-statistically significant difference as compared to the control group (100% vs. 83%, p = 0.1). During follow-up (1.1 years, interquartile range 0.6-1.3), one patient (4%) had a recurrence in the trans-jugular group, as opposed to eight (38%) in the control group (p = 0.006). No permanent complications occurred.
Conclusions: 3D cryoablation of right anterior-lateral, anterior, and anterior-septal/para-Hisian APs in children using a trans-jugular approach is extremely effective and safe, resulting in higher chronic success rate compared to the conventional femoral approach.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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