Zero-Fluoroscopy Ablation of Accessory Pathways in Children and Adolescents: CARTO3 Electroanatomic Mapping Combined with RF and Cryoenergy

Pacing and Clinical Electrophysiology : PACE
Marco ScaglioneFiorenzo Gaita

Abstract

Fluoroscopic catheter ablation of cardiac arrhythmias in pediatric patients exposes the patients to the potential risk of radiation considering the sensitivity of this population and its longer life expectancy. We evaluated the feasibility, safety, and efficacy of accessory pathway (AP) ablation guided by CARTO3 electroanatomic mapping (EAM) system with both cryoenergy and radiofrequency (RF) energy in order to avoid x-ray exposure in pediatric patients. We included 44 patients (mean age: 13.1 ± 3.3 years); nine of 44 presented concealed AP. An electrophysiological study with a three-dimensional EAM reconstruction was performed in every patient with a venous transfemoral direct right atrium approach or an arterial transfemoral retrograde approach to reach the mitral annulus. In two patients with left-sided AP, the ablation was performed via a patent foramen ovale. A total of 47 APs were present, left sided in 45% (21/47) of cases (15 lateral, one anterior, three posteroseptal, and two posterolateral) and right sided in 55% (26/47; one anterior, three anterolateral, one posterolateral, three lateral, five para-Hisian, 12 posteroseptal, and one anteroseptal). Ablation without the use of fluoroscopy was successfully performed in e...Continue Reading

References

May 30, 2002·Journal of Cardiovascular Electrophysiology·John D KuglerUNKNOWN Pediatric Radiofrequency Ablation Registry of the Pediatric Radiofrequency Ablation Registry of the Pediatric Electrophysiol
Sep 6, 2002·Journal of Cardiovascular Electrophysiology·Fabrizio DragoShoshana Leibovich
Jul 15, 2004·Journal of Cardiovascular Electrophysiology·George F Van HareUNKNOWN Pediatric Electrophysiology Society
Apr 27, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·George F Van HareUNKNOWN Participating Members of the Pediatric Electrophysiology Society
Sep 20, 2006·Pacing and Clinical Electrophysiology : PACE·John PapagiannisSpyridon Rammos
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Aug 3, 2012·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Grace WanJeremy P Moore
May 30, 2013·Pacing and Clinical Electrophysiology : PACE·Marco ScaglioneFiorenzo Gaita
Sep 17, 2013·Pacing and Clinical Electrophysiology : PACE·Hyo Soon AnJung Yun Choi
Sep 17, 2013·Pacing and Clinical Electrophysiology : PACE·Işil YildirimSema Özer

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Citations

Jun 30, 2016·European Heart Journal·Fiorenzo GaitaMatteo Anselmino
Aug 6, 2016·The International Journal of Cardiovascular Imaging·Matevž JanBorut Geršak
Feb 16, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Fabrizio DragoMassimo Stefano Silvetti
Sep 13, 2017·Pacing and Clinical Electrophysiology : PACE·Bradley C ClarkJeffrey P Moak
Nov 15, 2017·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Benjamin O'BrienRichard J Schilling
Feb 19, 2020·Journal of Cardiovascular Medicine·Marco ScaglioneFiorenzo Gaita
Oct 19, 2019·Journal of Arrhythmia·Rami FogelmanMoshe Swissa
Jun 28, 2018·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Marzia GiaccardiMassimo Milli
Mar 21, 2021·Revista Española De Cardiología·Javier Ramos-MaquedaLuis Tercedor-Sánchez
Mar 1, 2017·JACC. Clinical Electrophysiology·Shubhayan SanataniMichael J Ackerman

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