Transvenous cryoablation versus radiofrequency ablation of the slow pathway for the treatment of atrioventricular nodal re-entrant tachycardia: a prospective randomized pilot study.

Abstract:

AIMS:This is a prospective, randomized study comparing transvenous cryoablation with radiofrequency (RF) ablation of atrioventricular nodal re-entrant tachycardia (AVNRT). METHODS AND RESULTS:In this pilot trial, 200 patients with AVNRT were randomized to undergo cryoablation or RF ablation of the slow pathway. A 7 Fr 4-mm-tip cryocatheter (Cryocath) was used for cryomapping and cryoablation. Cryomapping was performed at the temperature of -30 degrees C to test the effect on the candidate ablation site. Following successful cryomapping, cryoablation was performed to produce an irreversible lesion by freezing to -75 degrees C. Procedural success, defined as elimination of the slow pathway or noninducibility of AVNRT, was achieved in 97/100 (97%) patients in the Cryo group vs. 98/100 (98%) patients in the RF group. No permanent complete AV-block occurred in either group. During a median of 246 days of follow-up, 8 patients in the Cryo group and 1 in the RF group had AVNRT recurrence. The cumulative incidence of primary endpoint (a combination of procedural failure, permanent complete AV-block and AVNRT recurrence) was significantly higher in the Cryo group than in the RF group (P=0.03, Log-rank test). CONCLUSIONS:The results of this pilot study indicate that transvenous cryoablation using a 4-mm-tip cryocatheter is associated with a comparable acute success rate but a higher recurrence rate as compared with RF ablation in patients with AVNRT. Potential benefits of cryoablation for ablation of AVNRT need to be determined in a larger multi-centre trial.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Zrenner B,Dong J,Schreieck J,Deisenhofer I,Estner H,Luani B,Karch M,Schmitt C

doi

10.1016/j.ehj.2004.07.020

subject

Has Abstract

pub_date

2004-12-01 00:00:00

pages

2226-31

issue

24

eissn

0195-668X

issn

1522-9645

pii

S0195-668X(04)00505-6

journal_volume

25

pub_type

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