Remote magnetic navigation shows superior long-term outcomes in pediatric atrioventricular (nodal) tachycardia ablation compared to manual radiofrequency and cryoablation

International Journal of Cardiology: Heart & Vasculature

Natasja M.S. de Groot¹  Sip Wijchers¹  Nawin L. Ramdat Misier¹  Sing-Chien Yap¹  Anna M.E. Noten¹  Tamas Szili-Torok¹  Thomas B. Krasemann²  Michiel Dalinghaus²  Janneke A.E. Kammeraad²  Ingrid M. van Beynum² 

[1] Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands1;Department of Pediatric Cardiology, Sophia Children’s Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands1;

关键词: Catheter ablation;    Remote magnetic navigation;    Cryoablation;    Radiofrequency ablation;    Supraventricular tachycardia;    Atrioventricular reentry tachycardia;   

DOI  :  

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown