Radiofrequency ablation of accessory pathways in children and congenital heart disease patients: impact of a nonfluoroscopic navigation system.

BACKGROUND

We sought to assess the impact of routine use of a nonfluoroscopic navigation system in the procedural aspects of radiofrequency ablation of accessory pathways (APs) in pediatric and congenital heart disease (CHD) patients and the reduction of fluoroscopy in different pathway locations.

METHODS

This was a retrospective review of 192 patients, divided in two groups: group A (76 patients, fluoroscopic only ablation) and group B (116 patients, combined use of fluoroscopy and a nonfluoroscopic system (NavX™). Comparison of procedural aspects (procedure time, fluoroscopy time, success, complications, and recurrences) was performed.

RESULTS

The two groups were comparable in terms of age, AP location, and presence of CHD. The mean age was 11.34 ± 4.65 years in group A versus 10.91 ± 3.68 years in group B. The procedure duration was significantly shorter in group B than in group A (177.06 ± 62.18 vs 242.45 ± 99.07) (P < 0.001). There was a significant reduction in the fluoroscopy time in group B compared to group A (8.27 ± 8.23 vs 39.77 ± 32.65 minutes) (P < 0.001). The difference between the two groups was statistically significant in all categories of APs. The success rate was 97.4% in group A and 96.6% in group B. There were no complications directly related to the use of the nonfluoroscopic system. There was no difference in the recurrence rate.

CONCLUSIONS

The use of a nonfluoroscopic system for catheter navigation resulted in significant reduction of total procedure and fluoroscopy time during catheter ablation of APs in pediatric and CHD patients, regardless of the location of the pathway, without a compromise in safety and efficacy.