Cryothermal ablation using time to tachycardia termination for AVNRT achieved an acute procedural success rate of 98.9% and a late recurrence rate of 3.7% without permanent AV block.
Observational (n=88)
No
Does cryothermal ablation using a 'time to tachycardia termination' approach improve outcomes and reduce late recurrence in patients with AVNRT?
A 'time to tachycardia termination' approach for cryoablation of AVNRT yields high acute procedural success (98.9%) and low late recurrence (3.7%) without the risk of permanent AV block.
PURPOSE: Cryothermal ablation (CTA) for atrioventricular nodal reentrant tachycardia (AVNRT) is considered safer than radiofrequency ablation (RFA) since it eliminates the risk of inadvertent AV block. However, it has not been widely adopted due to high late recurrence rate (LRR). In an effort to improve LRR, we evaluated a new approach to cryothermal mapping (CTM): "time to tachycardia termination" (TTT). METHODS: This single-center study had 88 consecutive patients who underwent CTA using TTT for AVNRT. The CTA catheter was positioned in sinus rhythm at the posteroseptal tricuspid annulus, and then AVNRT was induced. The CTA target site was identified by prompt tachycardia termination in ≤20 s during CTM. Procedural success was defined as no inducible AVNRT and ≤1 single AV nodal echoes. RESULTS: Acute procedural success was achieved in 87 of 88 patients (98.9 %) and was similar to prior studies for both CTA and RFA. No permanent AV block was observed. LRR was 3.7 % at a mean follow-up of 19.7 months. LRR was equivalent to that commonly reported for RFA and improved when compared to conventional CTA. CONCLUSION: TTT for CTA of AVNRT provides enhanced safety and similar long-term efficacy when compared to RFA. Based upon this experience, TTT provides an enhancement to conventional CTA that appears to result in improved long-term outcomes. In light of these findings, it seems reasonable to undertake additional randomized trials to determine whether RFA or CTA using TTT is the optimal approach for the catheter ablation of AVNRT.
Eryazici et al. (Wed,) conducted a observational in Atrioventricular nodal reentrant tachycardia (AVNRT) (n=88). Cryothermal ablation (CTA) using time to tachycardia termination (TTT) was evaluated on Acute procedural success (no inducible AVNRT and ≤1 single AV nodal echoes). Cryothermal ablation using time to tachycardia termination for AVNRT achieved an acute procedural success rate of 98.9% and a late recurrence rate of 3.7% without permanent AV block.