Pediatric/Adult Congenital Heart Disease -> Pediatric Cardiology D-PO03 - Poster Session III (ID 48) Poster

D-PO03-077 - Are We There Yet? The Impact Of Residual Slow Pathway Conduction With And Without Isoproterenol Following Cryoablation Of Atrioventricular Nodal Reentry Tachycardia (ID 1093)


Background: Cryoablation is increasingly used to treat atrioventricular nodal reentry tachycardia (AVNRT) due to a better safety profile. However, the optimal procedural endpoint remains undefined.
Objective: To identify procedural endpoints to aid in predicting recurrent AVNRT (rAVNRT) with cryoablation.
Methods: We performed a single-center, retrospective analysis of pediatric patients with AVNRT undergoing first-time cryoablation (2011 - 2019). Patients with acutely unsuccessful procedure (defined as ≥2 echo beats, n=6) were excluded. Procedural endpoints, including presence of jump or echo with and without isoproterenol, were at the discretion of the treating physician. Long-term recurrence status was identified from clinical notes or direct patient/family contact.
Results: A total of 256 patients met the inclusion criteria, 170 (66%) of whom were re-assessed on isoproterenol after ablation. Following ablation, 105 patients (41%) had some evidence of residual slow pathway (SP) conduction (jump or echo under any physiological condition) (Table 1). rAVNRT occurred in 13 patients (5%). On univariate analyses, SP presence under every condition was not associated with outcome. The presence of jump and echo without isoproterenol post ablation had a hazard ratio of 0.54 (95% CI 0.1 - 5.2, p = 0.56).
Conclusion: In this large study, the rate of rAVNRT after cryoablation was comparable to radiofrequency ablation. Residual SP conduction did not predict recurrence. Isoproterenol did not improve the prediction for rAVNRT.