Universität zu Köln

Emmel, M., Sreeram, N., Khalil, M. and Brockmeier, K. (2011). Cryoenergy for the ablation of paraseptal arrhythmogenic substrates in children and adolescents. Dtsch. Med. Wochenschr., 136 (43). S. 2187 - 2192. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-4413

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Abstract

Background and objective: Cryoablation is safe for the ablation of substrates in proximity to the AV node, because the initial lesion is reversible. We report our results of cryoablation in a transregional center for ablation in children and adolescents. Patients and methods: Data on 39 children and adolescents (4-18 years of age) who had been treated with cryo energy were analyzed retrospectively. The diagnosis was AV nodal reentry tachycardia (AVNRT; n = 30), para-Hisian accessory pathway (AP; n = 6) and congenital junctional ectopic tachycardia (JET; n = 4). In addition to non-inducibility, the targeted endpoint for AP-ablation was a missing or decremental concentric retrograde conduction, for ablation of AVNRT the endpoint was no slow pathway, no AH jumps and no echo-beats. The median follow-up was 3 years (270-1919 days). Results: The targeted endpoint was reached in 35/39 patients (90%), in four patients (10%) RF energy had to be applied. A recurrence occurred in 7/35 (20%) successfully treated patients. Two patients had a pre-excitation again after AP ablation, but no symptoms. Thus, 28/35 patients (80%) remained asymptomatic after cryoablation, and 26/35 (74%) are definitively cured, regarding all follow-up data. The subgroup of AVNRT patients does not differ from the entire group. There was no AV block in the cryoablation group. Conclusions: Cryoablation is very safe and effective for the definitive treatment of arrhythmias in children and adolescents. The price for the high safety is a reduced efficacy and a higher recurrence rate.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Emmel, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sreeram, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Khalil, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brockmeier, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-487794
DOI:	10.1055/s-0031-1292030
Journal or Publication Title:	Dtsch. Med. Wochenschr.
Volume:	136
Number:	43
Page Range:	S. 2187 - 2192
Date:	2011
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-4413
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NODAL REENTRANT TACHYCARDIA; RADIOFREQUENCY CATHETER ABLATION; PEDIATRIC-PATIENTS; CRYO-ABLATION; CRYOABLATION; EFFICACY; LOCALISA; SAFETY Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48779