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Europace Advance Access originally published online on May 17, 2009
Europace 2009 11(8):1065-1070; doi:10.1093/europace/eup121
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Electrophysiology and Ablation

Treatment of atrioventricular nodal re-entrant tachycardia by cryoablation with a 6 mm-tip catheter vs. radiofrequency ablation

Ngai Yin Chan*, Ngai Shing Mok, Chun Leung Lau, Ying Keung Lo, Chi Chung Choy, Suet Ting Lau and Yuen Choi Choi

Princess Margaret Hospital, 2-10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong

Aims: To compare recurrence rate and other procedural characteristics in patients undergoing atrioventricular nodal re-entrant tachycardia (AVNRT) treatment with catheter cryoablation (CRYO) delivered by 6 mm-tip catheter or radiofrequency (RF) ablation.

Methods and results: This is a retrospective case–control study including 80 patients with AVNRT treated with CRYO from March 2002 to June 2008. They were compared with another 80 consecutive patients who underwent RF ablation for AVNRT within the same period. Procedural success of 97.5 and 95% were achieved in CRYO and RF group, respectively. There was no permanent atrioventricular block (AVB) in the CRYO group, whereas two (2.5%) patients developed permanent first-degree or second-degree AVB in RF group (P = 0.155). Higher recurrence was found in the CRYO group (9 vs. 1.3%; P = 0.032) with no difference in the composite endpoint of procedural failure and recurrence between the groups (P = 0.263). There was significantly shorter fluoroscopy time (18.6 ± 10.8 vs. 25.9 ± 17.0 min; P = 0.002) and more energy applications required (3.1 ± 1.7 vs. 1.9 ± 1.1; P < 0.001) in the CRYO than the RF group.

Conclusion: Compared with RF ablation, CRYO with 6 mm-tip catheter for treating AVNRT results in higher recurrence and potentially lower incidence of permanent AVB. Fluoroscopy time has been shown to be reduced by CRYO.

Key Words: Cryoablation, Radiofrequency ablation, Atrioventricular nodal re-entrant tachycardia, Recurrence, Atrioventricular block

* Corresponding author. Tel: +852 29901111, Fax: +852 29903329, Email: ngaiyinchan{at}yahoo.com.hk

Manuscript submitted 9 March 2009. Accepted after revision 21 April 2009.


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