In pediatrics, supraventricular tachycardia (SVT) is a prevalent arrhythmia, often necessitating catheter ablation for effective care.
For pediatric supraventricular tachycardia, both radiofrequency ablation and cryoablation are effective and safe, with each offering distinct advantages.
In pediatrics, supraventricular tachycardia (SVT) is a prevalent arrhythmia, often necessitating catheter ablation for effective care. The two primary ablation techniques—radiofrequency ablation (RFA) and cryoablation (CA)—are commonly employed, though ongoing debate surrounds their relative safety and efficacy, and no definitive consensus exists on the optimal approach. This study examined the effectiveness and safety of RFA and CA in pediatric SVT.
In this systematic review and meta-analysis, an extensive search was carried out across major databases and clinical trial registries. Two authors independently screened studies and extracted relevant data using a standardized Excel sheet adapted from Cochrane’s template. Discrepancies were resolved by a third reviewer. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies were observational studies, non-randomized trials, and randomized controlled trials directly comparing RFA and CA in children with SVT.
Studies involving adult populations, lacking comparative analysis, or presented as case reports, case series, or conference abstracts were excluded. The primary outcomes were acute success and recurrence rates while secondary outcomes encompassed the duration of the procedure, incidence of complications, and fluoroscopy exposure time.
Acute success rates were high for both RFA and CA with no statistically significant difference. However, RFA was linked with a considerably lower recurrence rate (Table 1).
CA procedures tended to take longer (mean difference: 9.684 minutes, p = 0.437) but resulted in substantially lower fluoroscopy times (mean difference: 6.566 minutes, p = 0.032). Complication rates were comparable between groups, with a non-significant trend favoring RFA (Odds ratio: 0.363, p = 0.112).
RFA appears to yield more durable outcomes with lower recurrence rates, while CA offers the advantage of reduced fluoroscopy time and radiation exposure. The choice of technique must be individualized based on the arrhythmia’s characteristics and procedural considerations.
Cureus
Cryoablation Versus Radiofrequency Ablation in the Management of Pediatric Supraventricular Tachyarrhythmia: A Systematic Review and MetaAnalysis
Dost Jabarkhyl et al.
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