3D Non-Fluoroscopic Cryoablation of Right-Sided Accessory Pathways in Children:Monocentric Study and Literature Review  

作　　者：Fabrizio Drago Irma Battipaglia Pietro Paolo Tamborrino Luigina Porco Camilla Calvieri Mario Salvatore Russo Vincenzo Pazzano Romolo Remoli Massimo Stefano Silvetti 

机构地区：[1]Pediatric Cardiology and Cardiac Arrhythmias Unit,Department of Pediatric Cardiology and Cardiac Surgery,Bambino GesùChildren’s Hospital,IRCCS,Rome,Italy

出　　处：《Congenital Heart Disease》2021年第6期561-572,共12页先天性心脏病（英文）

摘　　要：Background:Cryoablation of accessory pathways(APs)is effective and very safe in children,as previously reported by our group.The aim of this retrospective study was to evaluate the current efficacy of 3D non-fluoroscopic cryoablation of right sided APs in children,comparing results obtained with the Ensite VelocityTM and the more recent Ensite PrecisionTM 3D mapping systems.Methods and Results:From January 2016 to December 2019,102 pediatric patients[mean age 12.5±2.8,62 males(61%of total cohort)]with right APs underwent 3D non-fluoroscopic transcatheter cryoablation at our Institution.Fifteen(14.7%)patients had previously undergone catheter ablation.Acute procedural success rate was 95.1%(n=97).No significant differences were detected in acute success rates achieved with Ensite Velocity^(TM)or Ensite PrecisionTM systems nor between manifest(94%)and concealed APs(100%).No permanent complications occurred.During follow-up(428±286 days,median 396 days[interquartile range 179-713]),19 patients(19.6%)had recurrences.Recurrences were more frequent for parahissian/anterior APs compared to midseptal/posterior and lateral APs(p=0.043).Recurrences were not related to the Ensite system used.A redo ablation procedure was attempted in 13 cases,11 cryoablation and 2 radiofrequency ablations:the former was successful in 10 cases out of 11(90.9%).Conclusion:3D cryoablation of right-sided APs is associated with a very high acute success rate with limited use of fluoroscopy,resulting in great benefit to the children.Recurrence rates are not high and patients can be retreated with cryo-energy with higher success rates.

关 键 词：3D Mapping accessory pathway CHILDREN CRYOABLATION pediatric tachyarrhythmias 

分 类 号：R54[医药卫生—心血管疾病]