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

Matta, Mario; Anselmino, Matteo; Scaglione, Mariano; Vitolo, Marco; Ferraris, Federico; Donna, Paolo Di; Caponi, Domenico; Castagno, Davide; Gaïta, Fiorenzo

doi:10.1007/s10840-016-0208-4

Cited by 15 publications

(10 citation statements)

References 31 publications

(34 reference statements)

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“…6,7 The 4-year actuarial recurrence rate of 13.3% was consistent with that found in the literature. 9 The HR of 3.7, when compared with RF ablation, was also similar to that reported in a large meta-analysis. 6 Comparing CA and RF end-procedural characteristics, there was no significant difference in terms of residual AH jump and persistent echo beat(s).…”

Section: Long-term Efficacy and Predictors Of Recurrences After Avnsupporting

confidence: 82%

Very long‐term outcomes after catheter ablation of atrioventricular nodal reentrant tachycardia: How does cryoenergy differ from radiofrequency?

Chaumont

Mirolo

Savouré

et al. 2020

Cardiovasc electrophysiol

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Introduction: Either cryoenergy or radiofrequency can be used during atrioventricular nodal reentrant tachycardia (AVNRT) ablation. There are still limited data comparing their respective long-term efficacy (>1 year). This study sought to compare the very long-term outcomes of AVNRT ablation using radiofrequency or cryotherapy. Methods: We retrospectively included all patients who had undergone a first AVNRT ablation in our institution between January 2010 and December 2017. The primary endpoint was recurrence of documented AVNRT. Results: The study population consisted of 409 patients (274 females; mean age, 49.9 years). Ablation was performed using cryoenergy in 260 patients and radiofrequency in 149. High acute procedural success rate (>98%) was obtained and no permanent AV block was observed using both techniques. During a mean follow-up of 3.3 ± 2.3 years, documented AVNRT recurrence occurred in 24 (9.2%) and 4 patients (2.7%) in the cryoablation (CA) and radiofrequency (RF) group, respectively. The risk of AVNRT recurrence was significantly higher in the CA group as compared with the RF group (hazard ratio [HR] = 3.7; 95% confidence interval [CI], 1.3-5.9). Most of the recurrences after CA occurred between 1-and 6-year follow-up (14/24; 58.3%), with one-third of late recurrences after 3-year follow-up. In multivariable analysis, only Koch's triangle anatomical variant was associated with AVNRT recurrence after CA (HR = 6.7; 95% CI, 2.7-16.3). Conclusion: While AVNRT recurrence rates were similar at 1 year of follow-up regardless of the energy used, long-term efficacy appeared higher after radiofrequency ablation. Strikingly, recurrences occured much later after cryotherapy compared with radiofrequency ablation.

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Section: Long-term Efficacy and Predictors Of Recurrences After Avnsupporting

confidence: 82%

Very long‐term outcomes after catheter ablation of atrioventricular nodal reentrant tachycardia: How does cryoenergy differ from radiofrequency?

Chaumont

Mirolo

Savouré

et al. 2020

Cardiovasc electrophysiol

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“…29 Cooling dynamic parameters, such as minimal temperature and time to reach the target cryoablation temperature, have also been reported to be related to outcome. 30…”

Section: Current Perspectives On Catheter Ablation Of Avnrtmentioning

confidence: 99%

<p>Atrioventricular Nodal Reentrant Tachycardia: Current Perspectives</p>

Matta¹,

Devecchi²,

Vecchi³

et al. 2020

RRCC

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Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common, highly symptomatic paroxysmal supraventricular tachycardia. Despite pharmacological treatment and vagal maneuvers for acute termination, catheter ablation has emerged as the first line treatment for the cure of AVNRT episodes. Several studies during recent years have investigated the efficacy, safety and long-term effect of both radiofrequency ablation and cryoablation of the slow pathway for the treatment of AVNRT. Innovations such as mapping systems and dedicated catheters have contributed by extending the indication to AVNRT ablation, even in particular subset populations such as children and congenital heart disease patients. We performed this review with the aim aim of summarizing and discussing current perspectives on the treatment of AVNRT, mainly focusing on catheter ablation energy sources and long-term results.

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“…[59][60][61] Cryoablation may carry a lower risk of AV blockage, but this mode of therapy is associated with a higher recurrence rate. [62][63][64]…”

Section: Prevention and Management Of Complications And Collateral Damentioning

confidence: 99%

Radiofrequency Catheter Ablation: How to Manage and Prevent Collateral Damage?

Baba

Sabayon

Refaat

2020

J Innov Cardiac Rhythm Manage.

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Radiofrequency catheter ablation has become the standard of care for the management of various arrhythmias and, in fact, the first-line therapy for many tachyarrhythmias. It entails creating scar tissue in the heart in regions where abnormal impulses form or propagate to restore normal cardiac conduction. As the heart is a complex organ and is surrounded by and related to many other anatomical structures, it is important to avoid the collateral damage that can happen from radiofrequency (RF) ablation on the endocardium as well as on the epicardium. This review explores methods for mitigating or limiting collateral damage during catheter ablation.

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

Cited by 15 publications

References 31 publications

Very long‐term outcomes after catheter ablation of atrioventricular nodal reentrant tachycardia: How does cryoenergy differ from radiofrequency?

Very long‐term outcomes after catheter ablation of atrioventricular nodal reentrant tachycardia: How does cryoenergy differ from radiofrequency?

<p>Atrioventricular Nodal Reentrant Tachycardia: Current Perspectives</p>

Radiofrequency Catheter Ablation: How to Manage and Prevent Collateral Damage?

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