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Europace Advance Access published online on July 4, 2009

Europace, doi:10.1093/europace/eup177
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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.


CLINICAL RESEARCH

Acute and long-term outcome of cryoablation therapy of typical atrioventricular nodal reentrant tachycardia

Hamid Bastani*, Jonas Schwieler, Per Insulander, Fariborz Tabrizi, Frieder Braunschweig, Göran Kennebäck, Nikola Drca, Bita Sadigh and Mats Jensen-Urstad

Department of Cardiology at the Karolinska Institute, Karolinska University Hospital, S-141 86 Stockholm, Sweden

Aims: The purpose of this study was to evaluate the safety and efficacy of cryoablation in a large series of patients with typical (slow–fast) atrioventricular nodal reentrant tachycardia (AVNRT).

Methods and results: Between 2003 and 2007, 312 patients with typical AVNRT—median age of 53 years (range 10–92), 200 women (64%)—underwent cryoablation, using exclusively a 6 mm tip catheter tip. Acute success was achieved in 309 of 312 patients (99%). The overall recurrence rate was 18 of 309 (5.8%) during a mean follow-up of 673 ± 381 days. Sixteen of these patients (89%) were successfully reablated. The recurrence rate was 9% in patients with residual dual atrioventricular (AV) nodal pathway post-ablation compared with 4% in those with complete elimination of slow pathway conduction (P = 0.05). No patient developed permanent AV block.

Conclusion: Cryoablation of AVNRT can be achieved with a high acute success rate and a reasonable recurrence rate at long-term follow-up. Complete abolition of slow pathway conduction seems to predict better late outcome.

Key Words: AV nodal reentrant tachycardia, Arrhythmia, Cryomapping, Cryoablation, Radiofrequency


* Corresponding author. Tel: +46 08 585 80000, Fax: +46 08 585 86710, Email: hamid.bastani{at}karolinska.se

Manuscript submitted 15 March 2009. Accepted after revision 10 June 2009.


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