Cryoablation of the right anteroseptal or midseptal accessory pathways in children: A 2‐year single‐center experience

BACKGROUND: Radiofrequency catheter ablation (RFCA) in the septum close to the atrioventricular node or His bundle has an increased risk of irreversible complications. Cryothermal energy has the advantages of reversible cryomapping and increased catheter stability. The study aims to evaluate the efficacy and safety of cryoablation of the right anteroseptal or midseptal accessory pathways (APs) in pediatric patients. METHOD: A retrospective review was performed with 26 pediatric patients (16 males and 10 females; median age 6.0 years and average body weight 24.9 kg) with paroxysmal supraventricular tachycardia (PSVT) in our Pediatric Heart Center from 2014 to 2016. Half of them had manifest APs. All the children underwent cryoablation for the treatment of PSVT because of the right anteroseptal or midseptal APs (16 cases had right anteroseptal APs and 10 cases had right midseptal APs). RESULTS: Acute cryoablation success was achieved in 23 cases (88%, 23/26). Atrioventricular block (AVB) occurred in eight cases (31%, 8/26) during the procedures and normal atrioventricular conduction recovered in seven cases except a case with I°AVB. During follow-up, three cases recurred (13%, 3/23) and no permanent high degree AVB was found. CONCLUSION: Cryoablation of the right anteroseptal or midseptal APs in pediatric patients is both safe and effective.