This work was presented at the American Heart Association Scientific Sessions on November 5, 2007.
Cryoablation for Atrioventricular Nodal Reentrant Tachycardia in Young Patients: Predictors of Recurrence
Article first published online: 28 AUG 2008
©2008, The Authors. Journal compilation ©2008, Blackwell Publishing, Inc.
Pacing and Clinical Electrophysiology
Volume 31, Issue 9, pages 1152–1159, September 2008
How to Cite
CHANANI, N. K., CHIESA, N. A., DUBIN, A. M., AVASARALA, K., VAN HARE, G. F. and COLLINS, K. K. (2008), Cryoablation for Atrioventricular Nodal Reentrant Tachycardia in Young Patients: Predictors of Recurrence. Pacing and Clinical Electrophysiology, 31: 1152–1159. doi: 10.1111/j.1540-8159.2008.01156.x
Dr. Chanani was supported by NIH NRSA HL007544.
Dr. Van Hare and Dr. Dubin receive research support from the Medtronic Corporation.
Dr. Collins did this work when she was faculty at University of California, San Francisco.
- Issue published online: 28 AUG 2008
- Article first published online: 28 AUG 2008
- Received March 21, 2008; revised May 14, 2008; accepted June 4, 2008.
- atrioventricular node;
- catheter ablation;
Background: Recurrence rates of atrioventricular nodal reentry tachycardia (AVNRT) after cryoablation continue to remain high despite excellent initial success rates. Our objective was to evaluate the clinical outcomes of cryoablation for AVNRT with the 4-mm and 6-mm tip cryoablation catheters in a young population and to elicit predictors of arrhythmia recurrence.
Methods: We retrospectively reviewed all patients who underwent cryoablation for AVNRT at the UCSF/Stanford Pediatric Arrhythmia Center from January 2004 to February 2007.
Results: One hundred fifty-four patients (age 13.7 years (3.2–24.4)) underwent cryoablation for AVNRT of which 144 patients had inducible AVNRT (123 sustained and 21 nonsustained) and 10 had presumed AVNRT. Initial success was achieved in 95% (146/154), with no difference between the 4-mm (93%) and 6-mm (98%) cryoablation catheter tips (P = 0.15). There was no permanent atrioventricular (AV) block. Transient third-degree AV block occurred in nine patients (6%), with no difference between the 4-mm (4%) and 6-mm (9%) tip (P = 0.13). AVNRT recurrence was documented in 14% in a median time of 2.5 months (0.25–20). Recurrences were lower with the 6-mm (9%) versus the 4-mm (18%) tip, but this did not reach statistical significance (P = 0.16). With univariate analysis, a longer fluoroscopy time was the only significant factor associated with recurrence. Multivariate analysis failed to identify any significant predictor of AVNRT recurrence.
Conclusion: Outcomes of cryoablation for AVNRT continue to be good without the complication of AV block. We could not identify any specific parameter associated with AVNRT recurrence. Further improvements in cryoablation technique will be necessary to reduce recurrences.