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REVIEW article

Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1506858
This article is part of the Research Topic New Challenges in Arrhythmology View all 5 articles

TRANSCATHETER ABLATION OF ATRIOVENTRICULAR NODAL REENTRY TACHYCARDIA IN CHILDREN AND CONGENITAL HEART DISEASE IN THE ERA OF 3D MAPPING

Provisionally accepted
Fabrizio Drago Fabrizio Drago *Francesco Flore Francesco Flore Cristina Raimondo Cristina Raimondo Claudio Pandozi Claudio Pandozi
  • San Paolo, Palidoro-Santa Marinella and Arrhythmology Cardiology Unit, Department of Cardiac Surgery, Cardiology and Heart Lung Transplant, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy

The final, formatted version of the article will be published soon.

    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.

    Keywords: Atrioventricular nodal reentry tachycardia, 3D mapping, Transcatheter ablation, Children, congenital heart disease

    Received: 06 Oct 2024; Accepted: 08 Nov 2024.

    Copyright: © 2024 Drago, Flore, Raimondo and Pandozi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Fabrizio Drago, San Paolo, Palidoro-Santa Marinella and Arrhythmology Cardiology Unit, Department of Cardiac Surgery, Cardiology and Heart Lung Transplant, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.