Remote magnetic navigation shows superior long-term outcomes in pediatric atrioventricular (nodal) tachycardia ablation compared to manual radiofrequency and cryoablation
| Autor: | Tamas Szili-Torok, Natasja M.S. de Groot, Thomas Krasemann, Ingrid M. van Beynum, Sip Wijchers, Michiel Dalinghaus, Janneke A.E. Kammeraad, Sing-Chien Yap, Anna Maria Elisabeth Noten, Nawin L. Ramdat Misier |
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| Přispěvatelé: | Cardiology, Pediatrics |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Tachycardia
Cryoablation medicine.medical_specialty Radiofrequency ablation medicine.medical_treatment Remote magnetic navigation CRYO cryoablation Catheter ablation Pediatrics MAN manual law.invention Atrioventricular nodal reentry tachycardia AVRT atrioventricular reentry tachycardia law Diseases of the circulatory (Cardiovascular) system Medicine DAP dose area product RF radiofrequency AVNRT atrioventricular nodal reentry tachycardia CA catheter ablation Original Paper business.industry Ablation medicine.disease EAM electro-anatomic mapping RMN remote magnetic navigation CHD congenital heart defect Supraventricular tachycardia RC666-701 SVT supraventricular tachycardia ECG electrocardiogram Radiology medicine.symptom Atrioventricular reentry tachycardia Cardiology and Cardiovascular Medicine business Energy source AP accessory pathway |
| Zdroj: | International Journal of Cardiology. Heart & Vasculature International Journal of Cardiology: Heart & Vasculature, Vol 37, Iss, Pp 100881-(2021) IJC Heart and Vasculature, 37:100881. Elsevier |
| ISSN: | 2352-9067 |
| Popis: | Background: Catheter ablation (CA) is the first-choice treatment for tachyarrhythmia in children. Currently available CA techniques differ in mechanism of catheter navigation and energy sources. There are no large studies comparing long-term outcomes between available CA techniques in a pediatric population with atrioventricular reentry tachycardia (AVRT) or atrioventricular nodal reentry tachycardia (AVNRT) mechanisms. Objective: This study aimed to compare procedural and long-term outcomes of remote magnetic navigation-guided radiofrequency (RF) ablation (RMN), manual-guided RF ablation (MAN) and manual-guided cryoablation (CRYO). Methods: This single-center, retrospective study included all first consecutive CA procedures for AVRT or AVNRT performed in children without structural heart disease from 2008 to 2019. Three study groups were defined by the ablation technique used: RMN, MAN or CRYO. Primary outcome was long-term recurrence of tachyarrhythmia. Results: In total, we included 223 patients, aged 14 (IQR 12–16) years; weighting 56 (IQR 47–65) kilograms. In total, 108 procedures were performed using RMN, 76 using MAN and 39 using CRYO. RMN had significantly lower recurrence rates compared to MAN and CRYO at mean follow-up of 5.5 ± 2.9 years (AVRT: 4.3% versus 15.6% versus 54.5%, P < 0.001; AVNRT: 7.7% versus 8.3% versus 35.7%, P = 0.008; for RMN versus MAN versus CRYO respectively). In AVNRT ablation, RMN had significantly lower fluoroscopy doses compared to CRYO [30 (IQR 20–41) versus 45 (IQR 29–65) mGy, P = 0.040). Conclusion: In pediatric patients without structural heart disease who underwent their first AV(N)RT ablation, RMN has superior long-term outcomes compared to MAN and CRYO, in addition to favorable fluoroscopy doses. |
| Databáze: | OpenAIRE |
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