{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:41:48Z","timestamp":1759970508540,"version":"build-2065373602"},"reference-count":16,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Catheter ablation of right anterior, anterior\u2013lateral, and anterior\u2013septal accessory pathways is still challenging in children, even after seminal improvements in mapping and catheter design over the last years. The trans-jugular approach was described as an alternative to the femoral vein recently. As a direct comparison between the femoral approach and the superior approach using the axillary vein was lacking, we conducted the present study. Methods: Twenty-two pediatric patients were enrolled in this retrospective study. Patients with prior ablation attempts were excluded. Another 22 consecutive patients with the same AP localizations were selected as a control group and treated with ablation through the femoral vein. Left axillary vein cannulation was performed advancing an 18-gauge needle using fluoroscopic landmarks (the first rib below the inferior border of the clavicle). All mapping and ablations of accessory pathways were performed with a 7 F deflectable radiofrequency ablation catheter. The main outcome of this study was ablation success at 1 year. Recurrences were defined as a relapse of preexcitation on a 12-lead electrocardiogram and\/or documented supraventricular tachycardia. Results: There were no significant differences in sex, age, or weight between groups. No complications occurred acutely or during follow-up. There were no significant differences in acute success rates between the two groups (19\/22 vs. 22\/22; p = 0.56) at 24 h ECG recordings. At the 1-year follow-up the total recurrence rate was 15.9% (7\/44 patients); there was a significantly lower recurrence rate among patients in the trans-jugular group (27.2% vs. 4.5%; p = 0.039). Conclusions: The present study suggests that the trans-axillary vein approach is a safe and effective alternative to the classical femoral approach in pediatric patients.<\/jats:p>","DOI":"10.3390\/jcm14030659","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T05:47:42Z","timestamp":1737438462000},"page":"659","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Trans-Axillary Vein Approach for the Ablation of Anterior\u2013Septal, Anterior, and Anterior\u2013Lateral Accessory Pathways in Children: More than an Alternative to the Femoral Vein"],"prefix":"10.3390","volume":"14","author":[{"given":"Paola","family":"Ferrari","sequence":"first","affiliation":[{"name":"ASST Papa Giovanni XXIII Hospital, 24123 Bergamo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5044-0069","authenticated-orcid":false,"given":"Giovanni","family":"Malanchini","sequence":"additional","affiliation":[{"name":"ASST Papa Giovanni XXIII Hospital, 24123 Bergamo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1860-9995","authenticated-orcid":false,"given":"Raul","family":"Limonta","sequence":"additional","affiliation":[{"name":"School of Medicine and Surgery, University of Milan-Bicocca, 20100 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Ferrari","sequence":"additional","affiliation":[{"name":"ASST Papa Giovanni XXIII Hospital, 24123 Bergamo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Leidi","sequence":"additional","affiliation":[{"name":"ASST Papa Giovanni XXIII Hospital, 24123 Bergamo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1144-5000","authenticated-orcid":false,"given":"Paolo","family":"De Filippo","sequence":"additional","affiliation":[{"name":"ASST Papa Giovanni XXIII Hospital, 24123 Bergamo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/j.hrthm.2019.12.008","article-title":"Outcomes of catheter ablation of anteroseptal and midseptal accessory pathways in pediatric patients","volume":"17 Pt. 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