Transcatheter ablation of atrioventricular nodal reentry tachycardia in children and congenital heart disease in the era of 3D mapping
Atrioventricular nodal reentrant tachycardia (AVNRT) is a common supraventricular tachycardia in children and congenital heart disease (CHD) patients. Nowadays, in large enough children, chronic treatment for symptomatic and recurrent AVNRT episodes relies on transcatheter ablation. Indeed, many thr...
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Frontiers Media S.A.
2024-11-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1506858/full |
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| author | Fabrizio Drago Francesco Flore Cristina Raimondo Claudio Pandozi |
| author_facet | Fabrizio Drago Francesco Flore Cristina Raimondo Claudio Pandozi |
| author_sort | Fabrizio Drago |
| collection | DOAJ |
| description | Atrioventricular nodal reentrant tachycardia (AVNRT) is a common supraventricular tachycardia in children and congenital heart disease (CHD) patients. Nowadays, in large enough children, chronic treatment for symptomatic and recurrent AVNRT episodes relies on transcatheter ablation. Indeed, many three-dimensional (3D) mapping strategies and ablation techniques have been developed and it helped to increase success rates and to reduce complications. Therefore, this study aimed to perform an updated comprehensive review of the available literature regarding contemporary management of AVNRT in children. A literature search was performed using Google Scholar, PubMed, Springer, Ovid, and Science Direct. We found that in recent times many investigations have demonstrated that 3D mapping systems allow to localize more precisely the ablation substrate, with minimal use of fluoroscopy. The most frequently employed mapping strategies are the low-voltage bridge strategy together with the search for the SP potential and the Sinus Rhythm Propagation Map with the identification of areas of Wave Collision or Pivot Points. For transcatheter ablation in pediatric settings, radiofrequency (RF) ablation was first used in the 1990s, while cryoablation was introduced in 2003 and nowadays represents the most used energy for AVNRT ablation in this population. Indeed, its specific features, such as reversible cryomapping, cryoadhesion and the precision in lesion delivery, made this technique very appealing to decrease complications and fluoroscopy time. As regards AVNRT in CHD patients, it represents the third most common form of arrhythmia in children with CHD. However, in this subgroup ablation remains challenging and experience limited, since anatomy may be atypical and the areas of ablation less predictable or less accessible. |
| format | Article |
| id | doaj-art-acb2e757023d4538bbca3cbed499cfb1 |
| institution | OA Journals |
| issn | 2297-055X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-acb2e757023d4538bbca3cbed499cfb12025-08-20T01:54:19ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-11-011110.3389/fcvm.2024.15068581506858Transcatheter ablation of atrioventricular nodal reentry tachycardia in children and congenital heart disease in the era of 3D mappingFabrizio DragoFrancesco FloreCristina RaimondoClaudio PandoziAtrioventricular nodal reentrant tachycardia (AVNRT) is a common supraventricular tachycardia in children and congenital heart disease (CHD) patients. Nowadays, in large enough children, chronic treatment for symptomatic and recurrent AVNRT episodes relies on transcatheter ablation. Indeed, many three-dimensional (3D) mapping strategies and ablation techniques have been developed and it helped to increase success rates and to reduce complications. Therefore, this study aimed to perform an updated comprehensive review of the available literature regarding contemporary management of AVNRT in children. A literature search was performed using Google Scholar, PubMed, Springer, Ovid, and Science Direct. We found that in recent times many investigations have demonstrated that 3D mapping systems allow to localize more precisely the ablation substrate, with minimal use of fluoroscopy. The most frequently employed mapping strategies are the low-voltage bridge strategy together with the search for the SP potential and the Sinus Rhythm Propagation Map with the identification of areas of Wave Collision or Pivot Points. For transcatheter ablation in pediatric settings, radiofrequency (RF) ablation was first used in the 1990s, while cryoablation was introduced in 2003 and nowadays represents the most used energy for AVNRT ablation in this population. Indeed, its specific features, such as reversible cryomapping, cryoadhesion and the precision in lesion delivery, made this technique very appealing to decrease complications and fluoroscopy time. As regards AVNRT in CHD patients, it represents the third most common form of arrhythmia in children with CHD. However, in this subgroup ablation remains challenging and experience limited, since anatomy may be atypical and the areas of ablation less predictable or less accessible.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1506858/fullatrioventricular nodal reentry tachycardia3D mappingtranscatheter ablationchildrencongenital heart disease |
| spellingShingle | Fabrizio Drago Francesco Flore Cristina Raimondo Claudio Pandozi Transcatheter ablation of atrioventricular nodal reentry tachycardia in children and congenital heart disease in the era of 3D mapping Frontiers in Cardiovascular Medicine atrioventricular nodal reentry tachycardia 3D mapping transcatheter ablation children congenital heart disease |
| title | Transcatheter ablation of atrioventricular nodal reentry tachycardia in children and congenital heart disease in the era of 3D mapping |
| title_full | Transcatheter ablation of atrioventricular nodal reentry tachycardia in children and congenital heart disease in the era of 3D mapping |
| title_fullStr | Transcatheter ablation of atrioventricular nodal reentry tachycardia in children and congenital heart disease in the era of 3D mapping |
| title_full_unstemmed | Transcatheter ablation of atrioventricular nodal reentry tachycardia in children and congenital heart disease in the era of 3D mapping |
| title_short | Transcatheter ablation of atrioventricular nodal reentry tachycardia in children and congenital heart disease in the era of 3D mapping |
| title_sort | transcatheter ablation of atrioventricular nodal reentry tachycardia in children and congenital heart disease in the era of 3d mapping |
| topic | atrioventricular nodal reentry tachycardia 3D mapping transcatheter ablation children congenital heart disease |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1506858/full |
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