Radiofrequency ablation vs. cryoablation for pediatric atrioventricular nodal reentrant tachycardia in the era of three-dimensional electroanatomical mapping
BackgroundCryoablation for pediatric atrioventricular nodal reentry tachycardia (AVNRT) is favored for reducing conduction system injury compared to radiofrequency (RF) ablation. The safety advantage of cryoablation over RF ablation primarily results from studies conducted without a three-dimensiona...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1527768/full |
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| author | Yao-Wei Chan Chieh-Mao Chuang Chieh-Mao Chuang Pi-Chang Lee I-Hsin Tai I-Hsin Tai I-Hsin Tai Ying-Hsuan Peng Ying-Hsuan Peng Wen-Po Fan Wen-Po Fan Yu-Shin Lee Ming-Chih Lin Ming-Chih Lin Sheng-Ling Jan Sheng-Ling Jan Yun-Ching Fu Yun-Ching Fu Shih-Ann Chen Shih-Ann Chen |
| author_facet | Yao-Wei Chan Chieh-Mao Chuang Chieh-Mao Chuang Pi-Chang Lee I-Hsin Tai I-Hsin Tai I-Hsin Tai Ying-Hsuan Peng Ying-Hsuan Peng Wen-Po Fan Wen-Po Fan Yu-Shin Lee Ming-Chih Lin Ming-Chih Lin Sheng-Ling Jan Sheng-Ling Jan Yun-Ching Fu Yun-Ching Fu Shih-Ann Chen Shih-Ann Chen |
| author_sort | Yao-Wei Chan |
| collection | DOAJ |
| description | BackgroundCryoablation for pediatric atrioventricular nodal reentry tachycardia (AVNRT) is favored for reducing conduction system injury compared to radiofrequency (RF) ablation. The safety advantage of cryoablation over RF ablation primarily results from studies conducted without a three-dimensional electroanatomical mapping (3D EAM) system. Currently, 3D EAM systems offer precise and efficient guidance, improving safety and outcomes. This study compares RF ablation and cryoablation using a 3D EAM system for pediatric AVNRT treatment.MethodsA retrospective study enrolled consecutive pediatric patients with AVNRT who underwent RF ablation (RF group) or cryoablation (Cryo group) guided by a 3D EAM system at multiple centers from July 2018 to January 2024.ResultsAmong 95 patients, 69 received RF ablation and 26 received cryoablation. Recurrence rates were 2.9% in the RF group and 0% in the Cryo group (p > 0.99), with no difference in AVNRT-free survival. No major complications, such as permanent atrioventricular (AV) block, were observed. The minor complication rates, including transient AV block, did not differ significantly (14.5% vs. 11.5%, p > 0.99). The RF group had a significantly shorter procedure time (111 vs. 153.5 min, p = 0.005). Ablation outside the low Koch triangle and cryoablation were independently associated with longer procedure times. The procedure time decreased significantly in the recent 50% of RF ablation cases, but not in cryoablation cases.ConclusionWith 3D EAM guidance, both RF ablation and cryoablation are considered safe and effective for pediatric AVNRT. RF ablation is more efficient with a shorter procedure time after increasing experience. |
| format | Article |
| id | doaj-art-9bab3320fb3941368d08e15dd55c32ac |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-9bab3320fb3941368d08e15dd55c32ac2025-01-30T06:23:05ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011210.3389/fcvm.2025.15277681527768Radiofrequency ablation vs. cryoablation for pediatric atrioventricular nodal reentrant tachycardia in the era of three-dimensional electroanatomical mappingYao-Wei Chan0Chieh-Mao Chuang1Chieh-Mao Chuang2Pi-Chang Lee3I-Hsin Tai4I-Hsin Tai5I-Hsin Tai6Ying-Hsuan Peng7Ying-Hsuan Peng8Wen-Po Fan9Wen-Po Fan10Yu-Shin Lee11Ming-Chih Lin12Ming-Chih Lin13Sheng-Ling Jan14Sheng-Ling Jan15Yun-Ching Fu16Yun-Ching Fu17Shih-Ann Chen18Shih-Ann Chen19Division of Pediatric Cardiology, Children’s Medical Center, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Pediatric Cardiology, Children’s Medical Center, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Cardiology, Department of Internal Medicine, Asia University Hospital, Taichung, TaiwanDivision of Pediatric Cardiology, Children’s Medical Center, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Pediatric Cardiology, Children’s Medical Center, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Cardiology, China Medical University Children’s Hospital, Taichung, TaiwanDepartment of Pediatrics, College of Medicine, China Medical University, Taichung, TaiwanDivision of Pediatric Cardiology, Children’s Medical Center, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Pediatric Cardiology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, TaiwanDivision of Pediatric Cardiology, Children’s Medical Center, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Pediatric Cardiology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Pediatric Cardiology, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, TaiwanDivision of Pediatric Cardiology, Children’s Medical Center, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, TaiwanDivision of Pediatric Cardiology, Children’s Medical Center, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, TaiwanDivision of Pediatric Cardiology, Children’s Medical Center, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, TaiwanCardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan0Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming Chiao-Tung University, Taipei, TaiwanBackgroundCryoablation for pediatric atrioventricular nodal reentry tachycardia (AVNRT) is favored for reducing conduction system injury compared to radiofrequency (RF) ablation. The safety advantage of cryoablation over RF ablation primarily results from studies conducted without a three-dimensional electroanatomical mapping (3D EAM) system. Currently, 3D EAM systems offer precise and efficient guidance, improving safety and outcomes. This study compares RF ablation and cryoablation using a 3D EAM system for pediatric AVNRT treatment.MethodsA retrospective study enrolled consecutive pediatric patients with AVNRT who underwent RF ablation (RF group) or cryoablation (Cryo group) guided by a 3D EAM system at multiple centers from July 2018 to January 2024.ResultsAmong 95 patients, 69 received RF ablation and 26 received cryoablation. Recurrence rates were 2.9% in the RF group and 0% in the Cryo group (p > 0.99), with no difference in AVNRT-free survival. No major complications, such as permanent atrioventricular (AV) block, were observed. The minor complication rates, including transient AV block, did not differ significantly (14.5% vs. 11.5%, p > 0.99). The RF group had a significantly shorter procedure time (111 vs. 153.5 min, p = 0.005). Ablation outside the low Koch triangle and cryoablation were independently associated with longer procedure times. The procedure time decreased significantly in the recent 50% of RF ablation cases, but not in cryoablation cases.ConclusionWith 3D EAM guidance, both RF ablation and cryoablation are considered safe and effective for pediatric AVNRT. RF ablation is more efficient with a shorter procedure time after increasing experience.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1527768/fullpediatricatrioventricular nodal reentrant tachycardiaradiofrequency ablationcryoablationelectroanatomical mapping systems |
| spellingShingle | Yao-Wei Chan Chieh-Mao Chuang Chieh-Mao Chuang Pi-Chang Lee I-Hsin Tai I-Hsin Tai I-Hsin Tai Ying-Hsuan Peng Ying-Hsuan Peng Wen-Po Fan Wen-Po Fan Yu-Shin Lee Ming-Chih Lin Ming-Chih Lin Sheng-Ling Jan Sheng-Ling Jan Yun-Ching Fu Yun-Ching Fu Shih-Ann Chen Shih-Ann Chen Radiofrequency ablation vs. cryoablation for pediatric atrioventricular nodal reentrant tachycardia in the era of three-dimensional electroanatomical mapping Frontiers in Cardiovascular Medicine pediatric atrioventricular nodal reentrant tachycardia radiofrequency ablation cryoablation electroanatomical mapping systems |
| title | Radiofrequency ablation vs. cryoablation for pediatric atrioventricular nodal reentrant tachycardia in the era of three-dimensional electroanatomical mapping |
| title_full | Radiofrequency ablation vs. cryoablation for pediatric atrioventricular nodal reentrant tachycardia in the era of three-dimensional electroanatomical mapping |
| title_fullStr | Radiofrequency ablation vs. cryoablation for pediatric atrioventricular nodal reentrant tachycardia in the era of three-dimensional electroanatomical mapping |
| title_full_unstemmed | Radiofrequency ablation vs. cryoablation for pediatric atrioventricular nodal reentrant tachycardia in the era of three-dimensional electroanatomical mapping |
| title_short | Radiofrequency ablation vs. cryoablation for pediatric atrioventricular nodal reentrant tachycardia in the era of three-dimensional electroanatomical mapping |
| title_sort | radiofrequency ablation vs cryoablation for pediatric atrioventricular nodal reentrant tachycardia in the era of three dimensional electroanatomical mapping |
| topic | pediatric atrioventricular nodal reentrant tachycardia radiofrequency ablation cryoablation electroanatomical mapping systems |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1527768/full |
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