Key result
6-mm tip cryoablation achieves similar acute success to 8-mm catheters in pediatric AVNRT.
Why the study?
Comparative data on different cryoablation catheter tip sizes in pediatric AVNRT were limited.
Does a 6-mm tip cryoablation catheter improve acute and long-term success compared to an 8-mm tip catheter in pediatric patients undergoing AVNRT ablation?
Cohort (n=129)
No
Does a 6-mm tip cryoablation catheter improve acute and long-term success compared to an 8-mm tip catheter in pediatric patients undergoing AVNRT ablation?
Absolute Event Rate: 100% vs 98.5%
p-value: p=> 0.05
Both 6-mm and 8-mm tip cryoablation catheters are highly effective and safe for treating pediatric AVNRT, allowing tip size to be tailored to patient size without compromising outcomes.
May allow tailoring cryoablation tip size to pediatric patient anatomy; leaves comparative long-term outcomes open.
BACKGROUND: Radiofrequency (RF) ablation has long been the standard treatment for atrioventricular nodal reentrant tachycardia (AVNRT) in children. However, cryoablation (CA) has gained popularity due to its safety profile and acceptable long-term success rates. Comparative data on different CA catheter tip sizes in pediatric AVNRT are limited. OBJECTIVE: To compare the acute and long-term outcomes of 6-mm vs. 8-mm tip CA catheters in pediatric patients undergoing AVNRT ablation. METHODS AND RESULTS: This retrospective single-center study included 129 pediatric patients (76 female, mean age 13 ± 3.0 years, mean weight 51.7 ± 15.7 kg) who underwent CA for AVNRT between January 2016 and December 2022. A 6-mm tip catheter was used in 64 patients and an 8-mm tip catheter in 65 patients. All procedures were performed using a three-dimensional electroanatomical mapping system (EAMS) (EnSite, Abbott/St. Jude Medical Inc., St. Paul, MN, USA), with minimal or no fluoroscopy in most cases. Acute success, recurrence rates, procedural parameters, and complications were compared between groups. Of the 129 patients, 126 (97.7%) had typical AVNRT and 3 (2.3%) had atypical AVNRT. The mean procedure time was 151.9 ± 43 min, with no significant difference between groups. Acute success rates were 100% in the 6-mm group and 98.5% in the 8-mm group (p > 0.05). The mean number of cryolesions was 8.5 ± 2.3 (6-mm) and 9.0 ± 2.5 (8-mm) (p > 0.05). Over a mean follow-up of 31.4 ± 26 months, recurrences occurred in six patients (4.6%), all successfully re-ablated. Long-term success rates were 94.4% overall, with no significant difference between groups. No permanent complications occurred; transient AV block was observed in one patient (0.7%). CONCLUSIONS: Both 6-mm and 8-mm CA catheters achieve high acute success and low recurrence rates in pediatric AVNRT with similar safety profiles. Catheter tip size can be tailored to patient age and weight without compromising efficacy. Minimal fluoroscopy approaches can be applied safely in the majority of cases.
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Özdemiroğlu et al. (2025) conducted a cohort in Pediatric atrioventricular nodal reentrant tachycardia (AVNRT) (n=129). 6-mm tip cryoablation catheter vs. 8-mm tip cryoablation catheter was evaluated on Acute success (p=> 0.05). In pediatric patients with AVNRT, 6-mm tip cryoablation catheters achieved similar acute success compared to 8-mm tip catheters (100% vs 98.5%, p>0.05).
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