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Long-term Outcome of Transcatheter Cryoablation for Atrioventricular Nodal Tachycardia and Septal Accessory Pathways
Session:
Sessão de Posters 37 - Estratégias avançadas em arritmias ventriculares e ablação
Speaker:
Marta Catarina Bernardo
Congress:
CPC 2026
Topic:
C. Arrhythmias and Device Therapy
Theme:
06. Supraventricular Tachycardia (non-AF)
Subtheme:
06.4 Supraventricular Tachycardia (non-AF) - Treatment
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Marta Catarina Bernardo; Fernando Nascimento Ferreira; Hélder Santos; Ana Lousinha; Guilherme Portugal; Bruno Valente; Pedro Sousa Cunha; Mário Oliveira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> For atrioventricular nodal tachycardia (AVNRT) and right-septal accessory pathways (AP) ablations with risk of atrioventricular (AV) block, cryoablation is accepted as a safer option. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Aim:</strong> Evaluate the efficacy, safety and recurrence rates of focal catheter cryoablation for the treatment of AVNRT and septal right-sided AP.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> We performed a retrospective single-center study of patients undergoing focal cryoablation between 2007 and 2025 with the electrophysiologic diagnosis of AVNRT or AP based on electrophysiological criteria. Clinical, electrophysiological, and follow-up data were systematically collected from hospital electronic medical records. Clinical characteristics, procedural data, safety and recurrence were analysed. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> We included 49 patients, median age 28 years (IQR 17–50) referred for the procedure due to Wolff-Parkinson-White syndrome (WPW, 55%); documented tachycardia (37%) and recurrent palpitations in the remaining patients. Seven patients had previously undergone radiofrequency ablation, with arrhythmia recurrence. Six patients were older than 65 years, and these ones had pre-existing slight conduction system abnormalities. Electrophysiologic evaluation revealed AVNRT in 30,6% and right septal AP in 69,4% (Table 1).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Acute procedural success was 82% in WPW and 100% in AVNRT. The unsuccessful cases involved low-risk AP in oligosymptomatic patients, one of them with transient AV block during application. All cases with a history of previous unsuccessful ablation/recurrence achieved acute success with cryoenergy and none experienced further recurrences during follow-up (FUP). Zero-fluoroscopy procedures were performed in 24% of cases. No major complications were reported. Over a median FUP of 13 (IQR 1-60) months, recurrence occurred in 5 patients (10,2%; 2 with AVRNT and 3 with AP) (Figure 1). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion:</strong> Cryoablation is an effective and safe approach for the treatment of patients with supraventricular arrhythmias involving the perinodal area, with good acute success rates, low recurrence rates and a favourable safety profile. These findings are especially relevant in younger patients where minimizing the risk of permanent AV block is critical. These results also suggest a role for cryoablation in<s> </s>older patients with baseline conduction system abnormalities.</span></span></p>
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