Impact of cryoablation catheter size on success rates in the treatment of atrioventricular nodal re-entry tachycardia in 160 patients with long-term follow-up

Sandilands, A. J.; Boreham, Philip; Crick, Jonathan C. Pitts; Cripps, Tim

doi:10.1093/europace/eun094

Cited by 54 publications

(55 citation statements)

References 13 publications

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“…Despite the comparable acute success rate, SP ablation by cryoenergy is still associated with a higher rate of arrhythmia recurrence than is SP ablation by RF 2,3 ; long-term success, however, may improve with increasing experience, while the high safety profile is maintained. 6 As previous studies [12][13][14] reported higher long-term success rate with use of the 6-mm rather than the 4-mm-tip ablation catheter, we chose to use the former for all patients. In fact, a larger tip catheter is expected to create wider lesions, which are likely to be associated with less recurrences at follow-up.…”

Section: Discussionmentioning

confidence: 99%

Cryoablation of typical AVNRT: Younger age and administration of bonus ablation favor long-term success

Pieragnoli¹,

Perini²,

Checchi³

et al. 2015

Heart Rhythm

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Section: Discussionmentioning

confidence: 99%

Cryoablation of typical AVNRT: Younger age and administration of bonus ablation favor long-term success

Pieragnoli¹,

Perini²,

Checchi³

et al. 2015

Heart Rhythm

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“…Overall, several factors have been investigated. It has been shown that the use of 6-mm tip catheters relates to a lower recurrence rate compared to 4-mm tip [11,26]. On the other hand, the role of number and duration of cryoenergy applications on long-term outcome is controversial [15,27,28].…”

Section: Cooling Dynamicsmentioning

confidence: 99%

“…Previous studies focused on identifying factors that could affect acute and long-term efficacy, such as catheter tip size [11], electrophysiological markers of residual dual AV node physiology [11,12], duration and number of cryoenergy applications [13], but data are limited and sometimes controversial, and no strong predictor of cryoablation long-term efficacy has been identified [14][15][16]. The aim of this study is to evaluate the safety, acute and long-term efficacy of AVNRT cryoablation and to identify intra-procedural predictors of long-term efficacy, focusing on both electrophysiological parameters and cooling dynamics.…”

Section: Introductionmentioning

confidence: 99%

Cooling dynamics: a new predictor of long-term efficacy of atrioventricular nodal reentrant tachycardia cryoablation

Matta

Anselmino

Scaglione

et al. 2016

J Interv Card Electrophysiol

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Purpose. Catheter ablation of the slow pathway is the most effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). Cryoenergy, compared to radiofrequency, relates to lower heart block risk, but higher incidence of AVNRT recurrences. The aim of this study is to confirm safety and efficacy of AVNRT cryoablation and to identify predictors of long-term recurrences. Conclusions. AVNRT cryoablation is safe and effective. Long-term recurrence rate was 11.7%. An ablation approach directed to the complete elimination of dual AV node physiology, along with assessment of tissue's cooling dynamics, hold the potential to improve long-term AVNRT cryoablation efficacy. Methods andAbstract word count: 244 2

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“…[7][8][9] The use of 6-mm-tip cryoablation catheters seems to enhance short-term success rates. 10,11 The present study was designed as a multicenter prospective randomized trial to test the hypothesis that cryoablation for AVNRT is as effective (both short term and long term) as RFCA with a lower risk of permanent AV block.…”

Section: Clinical Perspective On P 2245mentioning

confidence: 99%

Cryoablation Versus Radiofrequency Energy for the Ablation of Atrioventricular Nodal Reentrant Tachycardia (the CYRANO Study)

et al. 2010

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Background-Cryoablation has emerged as an alternative to radiofrequency catheter ablation (RFCA) for the treatment of atrioventricular (AV) nodal reentrant tachycardia (AVNRT). The purpose of this prospective randomized study was to test whether cryoablation is as effective as RFCA during both short-term and long-term follow-up with a lower risk of permanent AV block. Methods and Results-A total of 509 patients underwent slow pathway cryoablation (nϭ251) or RFCA (nϭ258). The primary end point was immediate ablation failure, permanent AV block, and AVNRT recurrence during a 6-month follow-up. Secondary end points included procedural parameters, device functionality, and pain perception. Significantly more patients in the cryoablation group than the RFCA group reached the primary end point (12.6% versus 6.3%; Pϭ0.018). Whereas immediate ablation success (96.8% versus 98.4%) and occurrence of permanent AV block (0% versus 0.4%) did not differ, AVNRT recurrence was significantly more frequent in the cryoablation group (9.4% versus 4.4%; Pϭ0.029). In the cryoablation group, procedure duration was longer (138Ϯ54 versus 123Ϯ48 minutes; Pϭ0.0012) and more device problems occurred (13 versus 2 patients; Pϭ0.033). Pain perception was lower in the cryoablation group (PϽ0.001). Conclusions-Cryoablation for AVNRT is as effective as RFCA over the short term but is associated with a higher recurrence rate at the 6-month follow-up. The risk of permanent AV block does not differ significantly between cryoablation and RFCA. The potential benefits of cryoenergy relative to ablation safety and pain perception are counterbalanced by longer procedure times, more device problems, and a high recurrence rate. Clinical Trial Registration-URL: http://www.clinicaltrials.gov.

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Impact of cryoablation catheter size on success rates in the treatment of atrioventricular nodal re-entry tachycardia in 160 patients with long-term follow-up

Cited by 54 publications

References 13 publications

Cryoablation of typical AVNRT: Younger age and administration of bonus ablation favor long-term success

Cryoablation of typical AVNRT: Younger age and administration of bonus ablation favor long-term success

Cooling dynamics: a new predictor of long-term efficacy of atrioventricular nodal reentrant tachycardia cryoablation

Cryoablation Versus Radiofrequency Energy for the Ablation of Atrioventricular Nodal Reentrant Tachycardia (the CYRANO Study)

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