Safety and Efficacy of Cryoablation vs Radiofrequency Ablation of Septal Accessory Pathways: Systematic Review of the Literature and Meta-Analyses

Cryoablation of the right anteroseptal or midseptal accessory pathways in children: A 2‐year single‐center experience

“…Our study showed that occurrence of transient AVB during the procedure was 31% and no permanent high‐degree AVB occurred during follow‐up. This result conforms to a recent meta‐analysis on safety of septal AP cryoablation . This is related to one feature of cryoablation: cryomapping .…”

“…This result conforms to a recent meta-analysis on safety of septal AP cryoablation. 11 This is related to one feature of cryoablation: cryomapping. 12 The cryomapping model (-40 • C) may make the myocardial tissue temporarily loose electrophysiological activity and The presence of a His bundle potential at the ablation target is a risk factor of AVB.…”

Freezing at the His Bundle

“…Prior reports have consistently shown that cryoablation for substrate targets that are in close proximity to the AV node, is associated with a significantly lower incidence of heart block as compared to traditional RF ablation [ 10 ]. In a large systematic review [ 11 ], Atienza and colleagues reported the procedural results of 3,775 patients who underwent septal AP ablation using either cryo or RF energy. While the incidence of complete heart block was 2.8% with RF, there were no cases of persistent AV nodal injury with cryoablation.…”

“…Despite the beneficial safety profile, procedural success rates with cryoablation remain suboptimal as compared to RF [ 11 , 15 ]. Even in the present study 2/6 (33%) patients had early disease recurrence requiring a redo ablation.…”