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Nonfluoroscopic Catheter Navigation for Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Children
Author(s) -
PAPAGIANNIS JOHN,
TSOUTSINOS ALEXANDROS,
KIRVASSILIS GEORGE,
SOFIANIDOU IOANNA,
KOUSSI THEOFILI,
LASKARI CLEO,
KIAFFAS MARIA,
APOSTOLOPOULOU SOTIRIA,
RAMMOS SPYRIDON
Publication year - 2006
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2006.00472.x
Subject(s) - medicine , supraventricular tachycardia , fluoroscopy , tachycardia , group b , radiofrequency ablation , catheter , ablation , catheter ablation , group a , nuclear medicine , surgery , cardiology
Background: Radiofrequency catheter ablation (RCA) of supraventricular tachycardia (SVT) in children is highly successful but requires exposure to radiation. Nonfluoroscopic mapping systems may significantly reduce fluoroscopy time.Methods: Forty consecutive pediatric patients who underwent RCA for accessory pathways (AP) or AV nodal reentrant tachycardia (AVNRT) with use of a nonfluoroscopic navigation system (Ensite® NavX™) (group A) were compared retrospectively to 40 consecutive patients with similar diagnoses who underwent RCA with fluoroscopic guidance only (group B).Results: Group A (mean age 12.1 ± 2.9 years, mean weight 47 ± 13.9 kg) consisted of 11 patients (27.7%) with AVNRT and 29 (72.5%) with AP. Group B (mean age 10.9 ± 3.1 years, mean weight 47.1 ± 17.1 kg) consisted of 7 patients (17.5%) with AVNRT and 33 (82.5%) with AP. There were no significant differences in AP location, patients with congenital heart disease, and number of radiofrequency lesions. Fluoroscopy time was significantly shorter in group A than in group B (10.4 ± 6.1, range 3.1–28.8 minutes, vs 24.9 ± 16.0, range 4.4–82.0 minutes, P < 0.0001). Procedure duration was also significantly shorter in group A than in group B (170 ± 68.5, range 90–420 minutes, vs 218 ± 69.3, range 90–360 minutes, P < 0.0001). Initial success was 95% in group A and 100% in group B. Tachycardia recurrences occurred in two patients in group A (5%) and six patients in group B (15%). Final success, including repeat ablations for recurrences or failures, was 100% in both groups.Conclusions: The use of a nonfluoroscopic system for catheter navigation significantly reduced fluoroscopy exposure and total procedure duration of RCA of common SVT substrates in children.