Low Recurrence Rate in Treating Atrioventricular Nodal Reentrant Tachycardia with Triple Freeze‐Thaw Cycles

Qureshi, Muhammad Yasir; Ratnasamy, Christopher; Sokoloski, Mary C.; Young, Ming‐Lon

doi:10.1111/j.1540-8159.2012.03514.x

Cited by 16 publications

(17 citation statements)

References 41 publications

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“…atrial flutter), and further studies will determine their efficacy in children. Finally, as most studies on cryoablation of AVNRT in children report acute success rates ranging between 90 and 100%, RFCA was at least equally successful in our study cohort .…”

Section: Discussionsupporting

confidence: 64%

“…Probably, the advantage of creating a lesion, which is, depending on the freezing time, partially reversible, also accounts for a higher risk of only subtotal ablation of the arrhythmogenic substrate, which finally results in higher recurrence rates. Supporting these theories, two recently published studies found that a change of policy to a triple freeze-thaw technique, or the use of a larger (8 mm) tip catheter, resulted in remarkably low recurrence rates of 2% (9,10).…”

Section: Discussionmentioning

confidence: 94%

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Radiofrequency catheter ablation can be performed with high success rates and very low complication rates in children and adolescents

et al. 2014

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 94%

Radiofrequency catheter ablation can be performed with high success rates and very low complication rates in children and adolescents

et al. 2014

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“…no jump or echo beats [17]. Data from the pediatric literature suggests that acute success can be seen in 96.2% of patients, with a triple freeze-thaw cycle [16]. In this group, the recurrence rate was 2.0% (1 patient).…”

Section: Discussionmentioning

confidence: 82%

“…Despite this, the long term recurrence rate appears to be acceptable at 8%. Other recent studies suggest that improved outcomes with cryoablation of AVNRT, perhaps comparable to radiofrequency ablation, may be achieved with 8 mm tip catheters [13], [14], linear ablation in the inferior portion of Koch's triangle [15], freeze-thaw-freeze cycles [16], and eliminating slow pathway conduction completely i.e. no jump or echo beats [17].…”

Section: Discussionmentioning

confidence: 99%

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Pseudo cryomapping for ablation of atrioventricular nodal reentry tachycardia: A single center North American experience

Moondra

Greenberg

Gerling

et al. 2017

Indian Pacing and Electrophysiology Journal

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BackgroundMost literature for cryoablation of atrioventricular nodal reentry tachycardia (AVNRT) is based on −30 degree celsius cryomapping with 4 & 6 mm distal electrode catheters. The cryomapping mode is not available on the 6 mm cryocatheter in the United States. We describe a technique for ‘pseudo’ mapping at −80° using a 6 mm cryocatheter and report on short and long term outcomes.MethodsA retrospective analysis of all index cases (n = 253) of cryoablation of AVNRT at a single North American institution during the period of 2003–2010 was performed. The majority of cases utilized a 6 mm distal electrode tip catheter. Long term follow up (2.4 ± 1.8 years) was performed via review of the medical record and by questionnaire or telephone if necessary.ResultsAcute ablation success was achieved in 93% of cases, with transient conduction defects noted in 39% of cases, and long term conduction defects in 1.6% of cases (4 patients with PR prolongation, 2 of which were permanent). General anesthesia, male gender and presence of structural heart disease were more common in the acute failure cohort. The recurrence rate for AVNRT was 8%. These patients tended to be younger and had more transient A-V conduction defects during the index procedure than those without a recurrence.ConclusionsIn conclusion, anatomic cryoablation of AVNRT utilizing a 6 mm electrode catheter with mapping performed at −80° Celsius is a safe procedure with good long term efficacy. Transient A-V block during the index procedure increases the risk of late recurrence.

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Effects of Triple Cryoenergy Application on Lesion Formation and Coronary Arteries in the Developing Myocardium

et al. 2017

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To improve long-term outcome after cryoablation of substrates of supraventricular tachycardia, application of two and three consecutive freeze-thaw cycles has been performed. The effect of triple freeze-thaw cycles on lesion formation within developing myocardium and coronary arteries, however, has not been studied yet. In eight piglets (mean age 15 weeks, weight 15-20 kg), 30 cryolesions (three consecutive freeze-thaw cycles) were applied to the atrial aspect of both AV valve annuli (n = 18) as well as to ventricular myocardium below the valves (n = 12). Coronary angiography was performed before and after cryoenergy application. The animals were reevaluated by coronary angiography and intracoronary ultrasound (ICUS) after 48 h. All hearts were removed for histological examination of the lesions subsequently. After staining (hematoxylin-eosin, desmin immunohistochemistry), lesions was measured by planimetry with a digital virtual miscroscope analysis system and volumes of the cryolesions were calculated. Mean atrial lesion volume was 190.68 ± 167.53 mm (n = 18), and mean ventricular lesion volume was 184.34 ± 107.42 mm (n = 12). Compared with previously reported data on lesion volumes after single and double freeze-thaw cycles, lesions were significantly larger. Coronary arteries were unaffected on coronary angiography as well as on ICUS. No affection of coronary arteries was found on histological examination. Application of three consecutive freeze-thaw cycles resulted in increased lesion volume compared with single and double freeze-thaw cycles. No affection of the coronary arteries was evident. To evaluate the clinical benefit and safety of triple cryoenergy application for catheter ablation, prospective randomized trials are required.

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Low Recurrence Rate in Treating Atrioventricular Nodal Reentrant Tachycardia with Triple Freeze‐Thaw Cycles

Abstract: Triple FTC cryoablation lesions resulted in a low recurrence rate comparable to RF ablation in treating AVNRT without increased complications.

Cited by 16 publications

References 41 publications

Radiofrequency catheter ablation can be performed with high success rates and very low complication rates in children and adolescents

Radiofrequency catheter ablation can be performed with high success rates and very low complication rates in children and adolescents

Pseudo cryomapping for ablation of atrioventricular nodal reentry tachycardia: A single center North American experience

Effects of Triple Cryoenergy Application on Lesion Formation and Coronary Arteries in the Developing Myocardium

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