Gist Katja M, Bockoven John R, Lane John, Smith Grace, Clark John M
Division of Pediatric Cardiology, Heart Center, Akron Children's Hospital, One Perkins Square, Akron, OH 44308, USA.
J Cardiovasc Electrophysiol. 2009 Jun;20(6):637-42. doi: 10.1111/j.1540-8167.2008.01375.x. Epub 2009 Dec 15.
To compare the acute success and recurrence rate of cryoablation for left-sided accessory pathways (AP) with controls who underwent radiofrequency ablation (RFA) at the same institution.
Catheter cryoablation of supraventricular tachycardia (SVT) is considered to be a safer alternative a compared with RFA. At our institution, cryoablation has become the primary interventional modality for all APs. The reported success rates of cryoablation for AP-mediated tachycardia have generally been less favorable than for RFA. However, the location of AP may influence cryoablation outcome. Furthermore, there are little data available on cryoablation of left-sided pathways.
A chart review was performed for all patients undergoing cryoablation between August 2005 and August 2007. Twenty-nine patients (mean age 13 years, range 6-18 years) were identified with SVT secondary to left-sided AP. The data collected included patient age, height, weight, date of procedure, mapping, ablation and procedure time, pathway location, success, and recurrence. Cryoablation was performed via a transseptal approach. Procedural success and recurrence rate were compared with our most recent 28 patients undergoing RFA ablation.
Procedural success was achieved in 97% of patients in the cryoablation group, compared with 100% in the RFA control group. Recurrence rate in the cryoablation group was 1 of 24 (4.2%) patients compared with 4 of 28 (14%) patients in the RFA group over 12 months.
Cryoablation can be safely and effectively used in the treatment of left-sided AP. Long-term outcomes remain to be seen.
比较左侧旁路（AP）冷冻消融与在同一机构接受射频消融（RFA）的对照组的急性成功率和复发率。
与RFA相比，室上性心动过速（SVT）的导管冷冻消融被认为是一种更安全的替代方法。在我们机构，冷冻消融已成为所有AP的主要介入方式。报道的AP介导的心动过速冷冻消融成功率通常不如RFA。然而，AP的位置可能会影响冷冻消融结果。此外，关于左侧旁路冷冻消融的数据很少。
对2005年8月至2007年8月期间接受冷冻消融的所有患者进行病历回顾。确定29例（平均年龄13岁，范围6 - 18岁）继发于左侧AP的SVT患者。收集的数据包括患者年龄、身高、体重、手术日期、标测、消融和手术时间、旁路位置、成功率和复发率。冷冻消融通过经房间隔途径进行。将手术成功率和复发率与我们最近28例接受RFA消融的患者进行比较。
冷冻消融组97%的患者手术成功，而RFA对照组为100%。在12个月内，冷冻消融组24例患者中有1例（4.2%）复发，而RFA组28例患者中有4例（14%）复发。
冷冻消融可安全有效地用于左侧AP的治疗。长期结果还有待观察。
