Efficacy and Safety of Cryoenergy in the Ablation of Atrioventricular Reentrant Tachycardia Substrates in Children and Adolescents

Kriebel, Thomas; Broistedt, Claudia; Kroll, Maja; Sigler, Matthias; Paul, Thomas

doi:10.1111/j.1540-8167.2005.50054.x

Cited by 108 publications

(99 citation statements)

References 26 publications

(68 reference statements)

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“…5 Overall, cryoenergy might offer a less aggressive and more titrated way to alter tissue with a better safety profile than RFCA and a comparable success rate. [7][8][9] The use of 6-mm-tip cryoablation catheters seems to enhance short-term success rates. 10,11 The present study was designed as a multicenter prospective randomized trial to test the hypothesis that cryoablation for AVNRT is as effective (both short term and long term) as RFCA with a lower risk of permanent AV block.…”

Section: Clinical Perspective On P 2245mentioning

confidence: 99%

Cryoablation Versus Radiofrequency Energy for the Ablation of Atrioventricular Nodal Reentrant Tachycardia (the CYRANO Study)

et al. 2010

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Background-Cryoablation has emerged as an alternative to radiofrequency catheter ablation (RFCA) for the treatment of atrioventricular (AV) nodal reentrant tachycardia (AVNRT). The purpose of this prospective randomized study was to test whether cryoablation is as effective as RFCA during both short-term and long-term follow-up with a lower risk of permanent AV block. Methods and Results-A total of 509 patients underwent slow pathway cryoablation (nϭ251) or RFCA (nϭ258). The primary end point was immediate ablation failure, permanent AV block, and AVNRT recurrence during a 6-month follow-up. Secondary end points included procedural parameters, device functionality, and pain perception. Significantly more patients in the cryoablation group than the RFCA group reached the primary end point (12.6% versus 6.3%; Pϭ0.018). Whereas immediate ablation success (96.8% versus 98.4%) and occurrence of permanent AV block (0% versus 0.4%) did not differ, AVNRT recurrence was significantly more frequent in the cryoablation group (9.4% versus 4.4%; Pϭ0.029). In the cryoablation group, procedure duration was longer (138Ϯ54 versus 123Ϯ48 minutes; Pϭ0.0012) and more device problems occurred (13 versus 2 patients; Pϭ0.033). Pain perception was lower in the cryoablation group (PϽ0.001). Conclusions-Cryoablation for AVNRT is as effective as RFCA over the short term but is associated with a higher recurrence rate at the 6-month follow-up. The risk of permanent AV block does not differ significantly between cryoablation and RFCA. The potential benefits of cryoenergy relative to ablation safety and pain perception are counterbalanced by longer procedure times, more device problems, and a high recurrence rate. Clinical Trial Registration-URL: http://www.clinicaltrials.gov.

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Section: Clinical Perspective On P 2245mentioning

confidence: 99%

Cryoablation Versus Radiofrequency Energy for the Ablation of Atrioventricular Nodal Reentrant Tachycardia (the CYRANO Study)

et al. 2010

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“…3 In children and adolescents, data from the pediatric radiofrequency catheter ablation registry acquired more than a decade ago reported a significant number of recurrences with 71% freedom from AVNRT 3 years post ablation. 4 However, recent follow-up studies of pediatric patients after AVNRT ablation reported freedom from AVNRT between 84% and 100% with radiofrequency 2,5 and between 78% and 93% with cryoenergy, [6][7][8] respectively. These studies on a limited number of pediatric patients analyzed data on the follow-up of 1 to 3 years post ablation.…”

mentioning

confidence: 99%

Long-Term Follow-Up After Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in Children

Backhoff

Klehs

Müller

et al. 2016

Circ: Arrhythmia and Electrophysiology

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Background-Catheter ablation of the slow conducting pathway (SP) is treatment of choice for atrioventricular nodal reentrant tachycardia (AVNRT). Although there are abundant data on AVNRT ablation in adult patients, little is known about the long-term results ≥3 years after AVNRT ablation in pediatric patients. Methods and Results-Follow-up data from 241 patients aged ≤18 years who had undergone successful AVNRT ablation were analyzed. Median age at ablation had been 12.5 years, and median follow-up was 5.9 years. Radiofrequency current had been used in 168 patients (70%), whereas cryoenergy had been used in 73 patients (30%). Procedural end point of AVNRT ablation had been either SP ablation (no residual dual atrioventricular nodal physiology) or SP modulation (residual SP conduction allowing for a maximum of one atrial echo beat). After the initial AVNRT ablation, calculated freedom from AVNRT was 96% at 1 year, 94% at 3 years, 93% at 5 years, and 89% at 8 years. Age, sex, body weight, the choice of ablation energy, and the procedural end point of AVNRT ablation did not impact freedom from AVNRT. Six of 22 AVNRT recurrences (27%) occurred ≥5 years after ablation. No late complications including atrioventricular block were noted. Conclusions-Cumulatively, catheter ablation of AVNRT continued to be effective in >90% of our pediatric patients during the long-term course. A significant part of recurrences occurred >5 years post ablation. Body weight, energy source, and the end point of ablation had no impact on long-term results. No adverse sequelae were noted. (Circ Arrhythm Electrophysiol. 2016;9:e004264.

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“…Literature reports acute success of AVNRT cryoablation in children ranging from 75% to 100% with a recurrence rate up to 27% 8, [26][27][28][29][30][31] . In our population acute success rate was 100% without complications.…”

Section: Discussionmentioning

confidence: 99%

Single center experience of fluoroless AVNRT ablation guided by electroanatomic reconstruction in children and adolescents

Ebrille

Caponi

Siboldi

et al. 2013

European Heart Journal

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Efficacy and Safety of Cryoenergy in the Ablation of Atrioventricular Reentrant Tachycardia Substrates in Children and Adolescents

Abstract: Cryoablation of SVT substrates in pediatric patients was associated with a lower success rate compared to RF catheter ablation. Cryomapping decreased the number of permanent lesions but did not predict cryoablation outcome in all tachycardia substrates.

Cited by 108 publications

References 26 publications

Cryoablation Versus Radiofrequency Energy for the Ablation of Atrioventricular Nodal Reentrant Tachycardia (the CYRANO Study)

Cryoablation Versus Radiofrequency Energy for the Ablation of Atrioventricular Nodal Reentrant Tachycardia (the CYRANO Study)

Long-Term Follow-Up After Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in Children

Single center experience of fluoroless AVNRT ablation guided by electroanatomic reconstruction in children and adolescents

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