{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:32:15Z","timestamp":1781634735217,"version":"3.54.5"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cryoablation for pediatric atrioventricular nodal reentry tachycardia (AVNRT) is favored for reducing conduction system injury compared to radiofrequency (RF) ablation. The safety advantage of cryoablation over RF ablation primarily results from studies conducted without a three-dimensional electroanatomical mapping (3D EAM) system. Currently, 3D EAM systems offer precise and efficient guidance, improving safety and outcomes. This study compares RF ablation and cryoablation using a 3D EAM system for pediatric AVNRT treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study enrolled consecutive pediatric patients with AVNRT who underwent RF ablation (RF group) or cryoablation (Cryo group) guided by a 3D EAM system at multiple centers from July 2018 to January 2024.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 95 patients, 69 received RF ablation and 26 received cryoablation. Recurrence rates were 2.9% in the RF group and 0% in the Cryo group (<jats:italic>p<\/jats:italic>\u2009&amp;gt;\u20090.99), with no difference in AVNRT-free survival. No major complications, such as permanent atrioventricular (AV) block, were observed. The minor complication rates, including transient AV block, did not differ significantly (14.5% vs. 11.5%, <jats:italic>p<\/jats:italic>\u2009&amp;gt;\u20090.99). The RF group had a significantly shorter procedure time (111 vs. 153.5\u2005min, <jats:italic>p<\/jats:italic>\u2009=\u20090.005). Ablation outside the low Koch triangle and cryoablation were independently associated with longer procedure times. The procedure time decreased significantly in the recent 50% of RF ablation cases, but not in cryoablation cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>With 3D EAM guidance, both RF ablation and cryoablation are considered safe and effective for pediatric AVNRT. RF ablation is more efficient with a shorter procedure time after increasing experience.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1527768","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T06:26:58Z","timestamp":1738218418000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Radiofrequency ablation vs. cryoablation for pediatric atrioventricular nodal reentrant tachycardia in the era of three-dimensional electroanatomical mapping"],"prefix":"10.3389","volume":"12","author":[{"given":"Yao-Wei","family":"Chan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chieh-Mao","family":"Chuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pi-Chang","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Hsin","family":"Tai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Hsuan","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Po","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Shin","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Chih","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-Ling","family":"Jan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Ching","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Ann","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1093\/europace\/euaa325","article-title":"Pediatric catheter ablation at the beginning of the 21st century: results from the European multicenter pediatric catheter ablation registry \u2018EUROPA\u2019","volume":"23","author":"Krause","year":"2021","journal-title":"Europace"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e251","DOI":"10.1016\/j.hrthm.2016.02.009","article-title":"PACES\/HRS expert consensus statement on the use of catheter ablation in children and patients with congenital heart disease: developed in partnership with the pediatric and congenital electrophysiology society (PACES) and the heart rhythm society (HRS). Endorsed by the governing bodies of PACES, HRS, the American academy of pediatrics (AAP), the American Heart Association (AHA), and the association for European pediatric and congenital cardiology (AEPC)","volume":"13","author":"Philip Saul","year":"2016","journal-title":"Heart Rhythm"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e004264","DOI":"10.1161\/CIRCEP.116.004264","article-title":"Long-term follow-up after catheter ablation of atrioventricular nodal reentrant tachycardia in children","volume":"9","author":"Backhoff","year":"2016","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1093\/europace\/euw145","article-title":"Cryoablation of atrioventricular nodal re-entrant tachycardia: 7-year follow-up in 515 patients-confirmed safety but very late recurrences occur","volume":"19","author":"Insulander","year":"2017","journal-title":"Europace"},{"key":"B5","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1007\/s10840-020-00868-x","article-title":"Cryoablation with an 8-mm tip catheter for typical AVNRT in children: a single center 5-year experience","volume":"62","author":"Kafal\u0131","year":"2021","journal-title":"J Interv Card Electrophysiol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1111\/pace.13277","article-title":"Long-term outcomes following cryoablation of atrioventricular nodal reentrant tachycardia in children","volume":"41","author":"Karacan","year":"2018","journal-title":"Pacing Clin Electrophysiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1599","DOI":"10.1007\/s00246-022-02887-z","article-title":"Transitioning from radiofrequency ablation to cryoablation for treatment of pediatric atrioventricular nodal reentrant tachycardia: a single tertiary center experience","volume":"43","author":"Koca","year":"2022","journal-title":"Pediatr Cardiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1354","DOI":"10.1111\/jce.12247","article-title":"Cryoablation versus RF ablation for AVNRT: a meta-analysis and systematic review","volume":"24","author":"Hanninen","year":"2013","journal-title":"J Cardiovasc Electrophysiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1007\/s10840-013-9842-2","article-title":"Cryoablation versus radiofrequency ablation of atrioventricular nodal reentrant tachycardia","volume":"39","author":"Santangeli","year":"2014","journal-title":"J Interv Card Electrophysiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e022799","DOI":"10.1161\/JAHA.121.022799","article-title":"Radiofrequency catheter ablation for pediatric atrioventricular nodal reentrant tachycardia: impact of age on procedural methods and durable success","volume":"11","author":"O'Leary","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1658","DOI":"10.1111\/jce.15037","article-title":"Clinical predictors of heart block during atrioventricular nodal reentrant tachycardia ablation: a multicenter 18-year experience","volume":"32","author":"Makker","year":"2021","journal-title":"J Cardiovasc Electrophysiol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1016\/j.hrthm.2006.01.026","article-title":"Cryoablation versus radiofrequency ablation for treatment of pediatric atrioventricular nodal reentrant tachycardia: initial experience with 4-mm cryocatheter","volume":"3","author":"Collins","year":"2006","journal-title":"Heart Rhythm"},{"key":"B13","first-page":"122","article-title":"Cryoablation versus radiofrequency ablation for atrioventricular nodal reentrant tachycardia in children: long-term results","volume":"51","author":"Papagiannis","year":"2010","journal-title":"Hellenic J Cardiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2214","DOI":"10.1016\/j.jacep.2024.05.010","article-title":"Effect of ablation energy source on outcomes of slow pathway modification for AVNRT in children","volume":"10","author":"Shah","year":"2024","journal-title":"JACC Clin Electrophysiol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1007\/s10840-022-01419-2","article-title":"Efficacy and safety of zero-fluoroscopy approach for ablation of atrioventricular nodal reentry tachycardia: experience from more than 1000 cases","volume":"66","author":"\u015awi\u0119toniowska-M\u015bcisz","year":"2023","journal-title":"J Interv Card Electrophysiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1565","DOI":"10.1093\/europace\/euv344","article-title":"Near zerO fluoroscopic exPosure during catheter ablAtion of supRavenTricular arrhYthmias: the NO-PARTY multicentre randomized trial","volume":"18","author":"Casella","year":"2016","journal-title":"Europace"},{"key":"B17","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/j.ijcard.2017.01.128","article-title":"Radiofrequency catheter ablation of atrioventricular node reentrant tachycardia in children with limited fluoroscopy","volume":"236","author":"Swissa","year":"2017","journal-title":"Int J Cardiol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"337","DOI":"10.6515\/ACS.201807_34(4).20180326A","article-title":"Transcatheter cryoablation procedures without fluoroscopy in pediatric patients with atrioventricular nodal reentrant tachycardia: a single-center experience","volume":"34","author":"Balli","year":"2018","journal-title":"Acta Cardiol Sin"},{"key":"B19","doi-asserted-by":"publisher","first-page":"979577","DOI":"10.3389\/fcvm.2022.979577","article-title":"Safety and efficacy of zero-fluoroscopy catheter ablation for paroxysmal supraventricular tachycardia in Chinese children","volume":"9","author":"Cui","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1007\/s10840-020-00791-1","article-title":"Fluoroless radiofrequency and cryo-ablation of atrioventricular nodal reentry tachycardia in adults and children: a single-center experience","volume":"61","author":"Jan","year":"2021","journal-title":"J Interv Card Electrophysiol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"159","DOI":"10.14744\/AnatolJCardiol.2018.72687","article-title":"Electroanatomic mapping-guided pediatric catheter ablation with limited\/zero fluoroscopy","volume":"20","author":"Koca","year":"2018","journal-title":"Anatol J Cardiol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.1111\/pace.12183","article-title":"Single center experience of fluoroless AVNRT ablation guided by electroanatomic reconstruction in children and adolescents","volume":"36","author":"Scaglione","year":"2013","journal-title":"Pacing Clin Electrophysiol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.3390\/children10091513","article-title":"Zero-fluoroscopy catheter ablation of supraventricular tachycardias in the pediatric population","volume":"10","author":"Topalovi\u0107","year":"2023","journal-title":"Children (Basel)"},{"key":"B24","doi-asserted-by":"publisher","first-page":"476","DOI":"10.6515\/ACS.201909_35(5).20190211A","article-title":"Zero fluoroscopy during ablation of right-sided supraventricular tachycardia substrates in a pediatric population - initial experience in Taiwan","volume":"35","author":"Tseng","year":"2019","journal-title":"Acta Cardiol Sin"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1527768\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T06:27:01Z","timestamp":1738218421000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1527768\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,30]]},"references-count":24,"alternative-id":["10.3389\/fcvm.2025.1527768"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1527768","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,30]]},"article-number":"1527768"}}