Japan ablation registry: cryoablation in atrioventricular nodal reentrant tachycardia (“JARCANRET study”): results from large multicenter retrospective investigation

Okishige, Kaoru; Okumura, Ken; Tsurugi, Takuo; Yotsukura, Akihiko; Nanbu, Tadafumi; Sugiura, Hirotaka; Sanada, Akiko; Kondo, Yusuke; Takano, Masahiro; Keida, Takehiko; Fujita, Masaki; Kamiya, Hiroki; Tsuchiya, Kunihiko; Adachi, Kazumasa; Katoh, Yukinori; Hiroshima, Kenzo; Yamamoto, Kei; Ashikaga, Keiichi; Hoshiyama, Tadashi; Sasano, Tetsuo; Hirao, Kazuyuki

doi:10.1007/s10840-019-00585-0

Cited by 13 publications

(15 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In some previous reports, complete elimination of the slow pathway was associated with a low recurrence rate after cryoablation for AVNRT 17 . In contrast, in other reports, a persistent dual atrioventricular nodal physiology with or without echo beats was not associated with a high risk of recurrence 18 . In the present study, no recurrence of tachycardia was confirmed in patients with junctional rhythm, and the occurrence of junctional rhythm was not associated with complete elimination of the slow pathway.…”

Section: Discussioncontrasting

confidence: 69%

“…17 In contrast, in other reports, a persistent dual atrioventricular nodal physiology with or without echo beats was not associated with a high risk of recurrence. 18 In the present study, no recurrence of tachycardia was confirmed in patients with junctional rhythm, and the occurrence of junctional rhythm was not associated with complete elimination of the slow pathway. Although further studies with a greater number of patients are required for the validation of our results, it can be inferred that occurrence of junctional rhythm may be associated with a low risk of tachycardia recurrence.…”

Section: Follow-up and Recurrencesupporting

confidence: 44%

See 1 more Smart Citation

Junctional rhythm during cryoablation for typical atrioventricular nodal reentrant tachycardia

Nakano

Kondo

Kajiyama

et al. 2023

Cardiovasc electrophysiol

Self Cite

View full text Add to dashboard Cite

IntroductionCryoablation is being used as an alternative to radiofrequency (RF) ablation for atrioventricular nodal reentrant tachycardia (AVNRT) owing to the lower risk of atrioventricular block (AVB) compared to RF ablation. Junctional rhythm often occurs during successful application of RF ablation for AVNRT. In contrast, junctional rhythm has rarely been reported to occur during cryoablation. This retrospective study evaluated the characteristics of junctional rhythm during cryoablation for typical AVNRT.Methods and ResultsThis retrospective study included 127 patients in whom successful cryoablation of typical AVNRT was performed. Patients diagnosed with atypical AVNRT were excluded. Junctional rhythm appeared during cryofreezing in 22 patients (17.3%). These junctional rhythms appeared due to cryofreezing at the successful site in the early phase within 15 s of commencement of cooling. Transient complete AVB was observed in 10 of 127 patients (7.9%), and it was noted that atrioventricular conduction improved immediately after cooling was stopped in these 10 patients. No junctional rhythm was observed before the appearance of AVB. No recurrence of tachycardia was confirmed in patients in whom junctional rhythm occurred by cryofreezing at the successful site.ConclusionOccurrence of junctional rhythms during cryoablation is not so rare and can be considered a criterion for successful cryofreezing. Furthermore, junctional rhythm may be associated with low risk of recurrent tachycardia.

show abstract

Section: Discussioncontrasting

confidence: 69%

Section: Follow-up and Recurrencesupporting

confidence: 44%

Junctional rhythm during cryoablation for typical atrioventricular nodal reentrant tachycardia

Nakano

Kondo

Kajiyama

et al. 2023

Cardiovasc electrophysiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…The reported rate at which cryoablation directed to the slow pathway yields an acute success tends to be consistently lower than that yielded by RF ablation, 2,12 and studies have shown the chronic success rate following cryoablation of a slow pathway to range from 85.2% to 96.1% 11,14,17–20 . The success rate achieved among our study patients, even in the remote phase, was relatively higher.…”

Section: Discussionmentioning

confidence: 47%

“…Okishige et al 20 reported the latest multicenter study from Japan. The success rate was as high as our data, however, the follow‐up period was relatively short, half the duration of our study.…”

Section: Discussionmentioning

confidence: 99%

Cryofreezing for slow‐pathway modification in patients with slow‐fast AVNRT: Efficacy, safety, and electroanatomical relation between sites of transient AV block and sites of successful cryoablation

Fukuda

Wakamatsu

Nakatani

et al. 2021

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Introduction Cryoablation has emerged as an alternative to radiofrequency ablation for treating atrioventricular nodal reentrant tachycardia (AVNRT). The aim of this prospective study was to evaluate the efficacy and safety of cryoapplication at sites within the mid/high septal region of Koch's triangle and the relation between sites of transient AV block (AVB) and sites of successful cryoablation. Methods and Results Included were 45 consecutive patients undergoing slow‐fast AVNRT cryoablation. Initial delivery of cryoenergy was to the mid‐septal to high septal region of Koch's triangle. Transient AVB occurred during cryoenergy delivery in 62% (28/45) of patients. Median distance between sites at which cryofreezing successfully eliminated slow pathway conduction and sites of AVB was 4.0 (3.25–5.0) mm. Sites of successful cryoablation tended to be to the left and inferior to the AVB sites. The atrial/ventricular electrogram ratio was significantly lower at sites of successful cryoablation than at AVB sites (0.25 [0.17–0.56] vs. 0.80 [0.36–1.25], p < .001). Delayed discrete or fractionated atrial electrograms were recorded more frequently at sites of successful cryoablation than at AVB sites (78% vs. 20%, p < .001). No persistent AV conduction disturbance occurred, and 96% (43/45) of patients showed absence of recurrence at a median follow‐up time of 25.0 months. Conclusion Cryoablation of slow‐fast AVNRT and targeting the mid/high septal region of Koch's triangle was highly successful. AVB frequently emerged near the site at which the slow pathway was eliminated but always resolved by regulating the energy delivery under careful monitoring, and it may be distinguishable by its local electrogram features.

show abstract

“…10 By using cryothermal energy only for AVNRT ablation, in a multicenter retrospective study in Japan, Okishige et al reported an overall acute success rate of 99.3% and recurrence rate at 1 year of 3.9%. 11 In 274 children diagnosed as AVNRT, Karacan et al reported F I G U R E 3 Assessment of ablation location in different KT geometry. A, A case with a wide KT (ie, the lowest recorded HB (red dots) was high above the CSO roof).…”

Section: Discussionmentioning

confidence: 99%

Using coronary sinus ostium as the reference for the slow pathway ablation of atrioventricular nodal reentrant tachycardia in children

Young

Niu

2020

Journal of Arrhythmia

View full text Add to dashboard Cite

Background Successful slow pathway (SP) ablation sites for atrioventricular nodal reentrant tachycardia (AVNRT) are usually located inside the Koch's triangle (KT). This study aimed to determine the ablation site of SP using the coronary sinus (CS) ostium (CSO) as the reference and to evaluate the efficacy of the CSO‐guided SP ablation. Methods A regional geometry around the KT was constructed by 3D mapping in 52 consecutive patients under age 18 with AVNRT. SP cryoablation was performed. If initial cryoablation was unsuccessful or cryoablation was deemed not suitable, then radiofrequency (RF) ablation was performed. The successful ablation site direction relative to the CSO was expressed as o'clock with the CSO viewed as a clock. RESULTS Cryoablation was used as the primary energy source in 40 patients. Of which, 32 were successful and eight required additional RF ablation. Direct RF ablation was performed in 11 patients. Using the CSO as reference, the successful site with cryoablation was at its 2.2 ± 0.6 o'clock; the RF ablation success site was at CSO 2.7 ± 0.5 o'clock (P = .006). During a median follow‐up of 12 month, there was 98% success of SP ablation in these patients, with one patient with RF ablation had a tachycardia recurrence. Conclusions Using CSO as reference, the cryoablation site at its 2:00 o'clock and RF ablation at its 3:00 o'clock are highly efficacious for SP ablation with good short‐term outcomes, and may be a useful tool in guiding the ablation target for AVNRT.

show abstract

Japan ablation registry: cryoablation in atrioventricular nodal reentrant tachycardia (“JARCANRET study”): results from large multicenter retrospective investigation

Cited by 13 publications

References 24 publications

Junctional rhythm during cryoablation for typical atrioventricular nodal reentrant tachycardia

Junctional rhythm during cryoablation for typical atrioventricular nodal reentrant tachycardia

Cryofreezing for slow‐pathway modification in patients with slow‐fast AVNRT: Efficacy, safety, and electroanatomical relation between sites of transient AV block and sites of successful cryoablation

Using coronary sinus ostium as the reference for the slow pathway ablation of atrioventricular nodal reentrant tachycardia in children

Contact Info

Product

Resources

About