Skip to main content
SpringerLink
Log in

Slow pathway elimination for atrioventricular nodal reentrant tachycardia with the 8-mm tip cryoablation catheter: an 18-month follow-up study

  • Published:
Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

The 9-French 8-mm tip cryoablation catheter confers a high rate of acute slow pathway (SP) elimination and an acceptable short-term outcome in patients with atrioventricular nodal reentrant tachycardia (AVNRT). The aim of this study was to investigate the long-term outcome of patients treated with this electrode in this indication.

Methods

Eighty-two patients (female = 52) with a mean age of 54.9 ± 17.7 years underwent SP elimination for typical AVNRT with the 8-mm tip cryocatheter in our institution between November 2009 to June 2012. Clinical and procedural characteristics were prospectively collected.

Results

Acute procedural success defined as AVNRT non-inducibility at the end of the procedure was obtained in 81/82 patients (98.7 %). Mean procedure duration and fluoroscopy time were 74.4 ± 28.7 min (range, 35–160 min) and 8.7 ± 5.3 min (range, 2–26 min), respectively. Mean number of energy applications was 4.0 ± 2.4 (range, 2–15). No permanent atrioventricular block was observed. Transient atrioventricular block occurred in 12 patients (14.6 %). Traumatic fast pathway conduction block occurred in one patient before cryoenergy delivery. Using an intention-to-treat analysis, 78 patients (95.1 %) remained free of AVNRT recurrence during a mean follow-up of 17.8 ± 9.3 months.

Conclusions

This study confirmed that the 8-mm tip cryocatheter is both safe and highly effective for SP conduction elimination in patients with AVNRT and demonstrated a low recurrence rate during a long-term follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Skanes, A. C., Dubuc, M., Klein, G. J., Thibault, B., Krahn, A. D., Yee, R., et al. (2000). Cryothermal ablation of the slow pathway for the elimination of atrioventricular nodal reentrant tachycardia. Circulation, 102(23), 2856–2860.

    Article  PubMed  CAS  Google Scholar 

  2. Friedman, P. L., Dubuc, M., Green, M. S., Jackman, W. M., Keane, D. T., Marinchak, R. A., et al. (2004). Catheter cryoablation of supraventricular tachycardia: results of the multicenter prospective “frosty” trial. Heart Rhythm, 1(2), 129–138.

    Article  PubMed  Google Scholar 

  3. Chan, N. Y., Mok, N. S., Lau, C. L., Lo, Y. K., Choy, C. C., Lau, S. T., et al. (2009). Treatment of atrioventricular nodal re-entrant tachycardia by cryoablation with a 6 mm-tip catheter vs. radiofrequency ablation. Europace, 11(8), 1065–1070.

    Article  PubMed  Google Scholar 

  4. Deisenhofer, I., Zrenner, B., Yin, Y. H., Pitschner, H. F., Kuniss, M., Grossmann, G., et al. (2010). Cryoablation versus radiofrequency energy for the ablation of atrioventricular nodal reentrant tachycardia (the CYRANO Study): results from a large multicenter prospective randomized trial. Circulation, 122(22), 2239–2245.

    Article  PubMed  Google Scholar 

  5. Opel, A., Murray, S., Kamath, N., Dhinoja, M., Abrams, D., Sporton, S., et al. (2010). Cryoablation versus radiofrequency ablation for treatment of atrioventricular nodal reentrant tachycardia: cryoablation with 6-mm-tip catheters is still less effective than radiofrequency ablation. Heart Rhythm, 7(3), 340–343.

    Article  PubMed  Google Scholar 

  6. Schwagten, B., Knops, P., Janse, P., Kimman, G., Van Belle, Y., Szili-Torok, T., et al. (2011). Long-term follow-up after catheter ablation for atrioventricular nodal reentrant tachycardia: a comparison of cryothermal and radiofrequency energy in a large series of patients. J Interv Card Electrophysiol, 30(1), 55–61.

    Article  PubMed  Google Scholar 

  7. Drago, F., Russo, M. S., Silvetti, M. S., DE Santis, A., Iodice, F., & Naso Onofrio, M. T. (2010). Cryoablation of typical atrioventricular nodal reentrant tachycardia in children: six years’ experience and follow-up in a single center. Pacing Clin Electrophysiol, 33(4), 475–481.

    Article  PubMed  Google Scholar 

  8. Gupta, D., Al-Lamee, R. K., Earley, M. J., Kistler, P., Harris, S. J., Nathan, A. W., et al. (2006). Cryoablation compared with radiofrequency ablation for atrioventricular nodal re-entrant tachycardia: analysis of factors contributing to acute and follow-up outcome. Europace, 8(12), 1022–1026.

    Article  PubMed  Google Scholar 

  9. Rivard, L., Dubuc, M., Guerra, P. G., Novak, P., Roy, D., Macle, L., et al. (2008). Cryoablation outcomes for AV nodal reentrant tachycardia comparing 4-mm versus 6-mm electrode-tip catheters. Heart Rhythm, 5(2), 230–234.

    Article  PubMed  Google Scholar 

  10. Dumont, F., Khairy, P., Guerra, P. G., Talajic, M., Roux, J. F., Thibault B., et al. (2007). Initial experience with an 8 mm tip cryocatheter for slow pathway modification in AV nodal reentrant tachycardia (AVNRT). Abstract HRS 2007.

  11. Silver, E. S., Silva, J. N., Ceresnak, S. R., Chiesa, N. A., Rhee, E. K., Dubin, A. M., et al. (2010). Cryoablation with an 8-mm tip catheter for pediatric atrioventricular nodal reentrant tachycardia is safe and efficacious with a low incidence of recurrence. Pacing Clin Electrophysiol, 33(6), 681–686.

    Article  PubMed  Google Scholar 

  12. Chan, N. Y., Mok, N. S., Choy, C. C., Lau, C. L., Chu, P. S., Yuen, H. C., et al. (2012). Treatment of atrioventricular nodal re-entrant tachycardia by cryoablation with an 8-mm-tip catheter versus radiofrequency ablation. J Interv Card Electrophysiol, 34(3), 295–301.

    Article  PubMed  Google Scholar 

  13. Jackman, W. M. (1995). Three forms of atrioventricular nodal (junctional) reentrant tachycardia: differential diagnosis, electrophysiological characteristics, and implications for anatomy of the reentrant circuit. Cardiac Electrophysiology. From cell to bedside. Philadelphia, PA: WB Saunders.

    Google Scholar 

  14. Khairy, P., Rivard, L., Guerra, P. G., Tanguay, J. F., Mawad, W., Roy, D., et al. (2008). Morphometric ablation lesion characteristics comparing 4, 6, and 8 mm electrode-tip cryocatheters. J Cardiovasc Electrophysiol, 19(11), 1203–1207.

    Article  PubMed  Google Scholar 

  15. Wood, M. A., Parvez, B., Ellenbogen, A. L., Shaffer, K. M., Goldberg, S. M., Gaspar, M. P., et al. (2007). Determinants of lesion sizes and tissue temperatures during catheter cryoablation. Pacing Clin Electrophysiol, 30(5), 644–654.

    Article  PubMed  Google Scholar 

  16. Thornton, A. S., Janse, P., Alings, M., Scholten, M. F., Mekel, J. M., Miltenburg, M., et al. (2008). Acute success and short-term follow-up of catheter ablation of isthmus-dependent atrial flutter; a comparison of 8 mm tip radiofrequency and cryothermy catheters. J Interv Card Electrophysiol, 21(3), 241–248.

    Article  PubMed  CAS  Google Scholar 

  17. Collins, N. J., Barlow, M., Varghese, P., & Leitch, J. (2006). Cryoablation versus radiofrequency ablation in the treatment of atrial flutter trial (CRAAFT). J Interv Card Electrophysiol, 16(1), 1–5.

    Article  PubMed  Google Scholar 

  18. Malmborg, H., Lönnerholm, S., & Lundqvist, C. B. (2009). A prospective randomized comparison of large-tip cryoablation and 8-mm-tip radiofrequency catheter ablation of atrial flutter. J Interv Card Electrophysiol, 24(2), 127–131.

    Article  PubMed  Google Scholar 

  19. Montenero, A. S., Bruno, N., Zumbo, F., Antonelli, A., Fiocca, L., Barbieri, L., et al. (2005). Cryothermal ablation treatment of atrial flutter—experience with a new 9 French 8 mm tip catheter. J Interv Card Electrophysiol, 12(1), 45–54.

    Article  PubMed  Google Scholar 

  20. Montenero, A. S., Bruno, N., Antonelli, A., Mangiameli, D., Barbieri, L., Andrew, P., et al. (2005). Comparison between a 7 French 6 mm tip cryothermal catheter and a 9 French 8 mm tip cryothermal catheter for cryoablation treatment of common atrial flutter. J Interv Card Electrophysiol, 13(1), 59–69.

    Article  PubMed  Google Scholar 

  21. Sandilands, A., Boreham, P., Pitts-Crick, J., & Cripps, T. (2008). 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. Europace, 10(6), 683–686.

    Article  PubMed  Google Scholar 

  22. De Sisti, A., Tonet, J., Gueffaf, F., Touil, F., Leclercq, J. F., Aouate, P., et al. (2008). Effects of inadvertent atrioventricular block on clinical outcomes during cryoablation of the slow pathway in the treatment of atrioventricular nodal re-entrant tachycardia. Europace, 10(12), 1421–1427.

    Article  PubMed  Google Scholar 

  23. De Sisti, A., & Tonet, J. (2012). Cryoablation of atrioventricular nodal reentrant tachycardia: a clinical review. Pacing Clin Electrophysiol, 35(2), 233–240.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, Hôpital Nord, Aix-Marseille Université, Marseille, France

    Michaël Peyrol, Pascal Sbragia, Sabrina Uhry, Gilles Boccara, Eric Dolla, Amandine Quatre, Maxime Guenoun, Samuel Lévy & Franck Paganelli

Authors
  1. Michaël Peyrol
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pascal Sbragia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sabrina Uhry
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gilles Boccara
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eric Dolla
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Amandine Quatre
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Maxime Guenoun
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Samuel Lévy
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Franck Paganelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michaël Peyrol.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Peyrol, M., Sbragia, P., Uhry, S. et al. Slow pathway elimination for atrioventricular nodal reentrant tachycardia with the 8-mm tip cryoablation catheter: an 18-month follow-up study. J Interv Card Electrophysiol 37, 105–109 (2013). https://doi.org/10.1007/s10840-012-9768-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10840-012-9768-0

Keywords

Search

Navigation