Outcome of combined cryo‐ and radiofrequency‐catheter ablation in patients with supraventricular tachycardias

Miyamoto, Koji; Kapa, Suraj; Mulpuru, Siva K.; Deshmukh, Abhishek; Asirvatham, Samuel J.; Munger, Thomas M.; Friedman, Paul A.; Packer, Douglas L.

doi:10.1111/jce.14068

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…required additional RF ablation to achieve final success, with one failed ablation. 10 By using cryothermal energy only for AVNRT ablation, in a multicenter retrospective study in Japan, Okishige et al reported an overall acute success rate of 99.3% and recurrence rate at 1 year of 3.9%. 11 In 274 children diagnosed as AVNRT, Karacan et al reported F I G U R E 3 Assessment of ablation location in different KT geometry.…”

Section: Discussionmentioning

confidence: 99%

Using coronary sinus ostium as the reference for the slow pathway ablation of atrioventricular nodal reentrant tachycardia in children

Young

Niu

2020

Journal of Arrhythmia

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Background Successful slow pathway (SP) ablation sites for atrioventricular nodal reentrant tachycardia (AVNRT) are usually located inside the Koch's triangle (KT). This study aimed to determine the ablation site of SP using the coronary sinus (CS) ostium (CSO) as the reference and to evaluate the efficacy of the CSO‐guided SP ablation. Methods A regional geometry around the KT was constructed by 3D mapping in 52 consecutive patients under age 18 with AVNRT. SP cryoablation was performed. If initial cryoablation was unsuccessful or cryoablation was deemed not suitable, then radiofrequency (RF) ablation was performed. The successful ablation site direction relative to the CSO was expressed as o'clock with the CSO viewed as a clock. RESULTS Cryoablation was used as the primary energy source in 40 patients. Of which, 32 were successful and eight required additional RF ablation. Direct RF ablation was performed in 11 patients. Using the CSO as reference, the successful site with cryoablation was at its 2.2 ± 0.6 o'clock; the RF ablation success site was at CSO 2.7 ± 0.5 o'clock (P = .006). During a median follow‐up of 12 month, there was 98% success of SP ablation in these patients, with one patient with RF ablation had a tachycardia recurrence. Conclusions Using CSO as reference, the cryoablation site at its 2:00 o'clock and RF ablation at its 3:00 o'clock are highly efficacious for SP ablation with good short‐term outcomes, and may be a useful tool in guiding the ablation target for AVNRT.

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Section: Discussionmentioning

confidence: 99%

Using coronary sinus ostium as the reference for the slow pathway ablation of atrioventricular nodal reentrant tachycardia in children

Young

Niu

2020

Journal of Arrhythmia

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Transcatheter cryo-ablation of septal accessory pathways, multicenter observational study in Japan

Okishige

Yamauchi

Nagase

et al. 2021

Journal of Cardiology

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An observational study on efficacy of atrioventricular nodal slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia and its influence on atrioventricular conduction function

Wang,

2024

Medicine

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The study aimed to evaluate the effectiveness of atrioventricular nodal slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia (AVNRT) and examine its impact on the atrioventricular conduction function. A retrospective analysis was performed on the clinical data of 90 AVNRT patients who underwent radiofrequency ablation at our institution between August 2018 and February 2021. Based on the presence or absence of slow pathway conduction during the procedure, patients were classified into the slow pathway elimination group (SPE group) and the slow pathway improvement group (SPI group). Procedure-related parameters, His bundle electrogram, atrioventricular nodal effective refractory period (AVN-ERP), Wenckebach point of anterograde atrioventricular nodal conduction (AVN-WKB), Wenckebach point of retrograde atrioventricular nodal conduction (VAV-WKB), myocardial function were compared between the 2 groups. Additionally, the recurrence rates 1 and 2 years post-ablation were noted. Both groups reported a 100% success rate for the procedure. Post-ablation, 42 patients exhibited persisting atrioventricular nodal slow pathway, whereas 48 showed its disappearance, signifying the absence of the jump phenomenon and atrial echo. Post-ablation, the SPI group showed an increase in slow pathway AVN-ERP compared to pre-ablation values (P < .05), with no significant change in the fast pathway AVN-ERP (P > .05). The SPE group showed a reduction in both slow pathway and fast pathway AVN-ERP post-ablation (P < .05). Post-ablation, both slow pathway and fast pathway AVN-ERP in the SPI group were higher than in the SPE group (P < .05). AVN-WKB and VAV-WKB values increased in both groups after ablation (P < .05). There were no recurrences 1 or 2 years after ablation in the SPE group and 1 case of recurrence 2 years after ablation in the SPI group (2.38%). Different ablation endpoints during radiofrequency ablation had no apparent impact on atrioventricular conduction time, recurrence rate, and myocardial function in patients with AVNRT, but they advanced AVN-WKB and VAV-WKB. Slow pathway improvement led to an elongation of slow pathway AVN-ERP, while slow pathway elimination resulted in a reduction of both slow pathway and fast pathway AVN-ERP.

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Outcome of combined cryo‐ and radiofrequency‐catheter ablation in patients with supraventricular tachycardias

Cited by 3 publications

References 26 publications

Using coronary sinus ostium as the reference for the slow pathway ablation of atrioventricular nodal reentrant tachycardia in children

Using coronary sinus ostium as the reference for the slow pathway ablation of atrioventricular nodal reentrant tachycardia in children

Transcatheter cryo-ablation of septal accessory pathways, multicenter observational study in Japan

An observational study on efficacy of atrioventricular nodal slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia and its influence on atrioventricular conduction function

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