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Europace Advance Access published online on January 26, 2009
Europace, doi:10.1093/europace/eup004
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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

Safety and efficacy of cryoablation of atrial tachycardia with high risk of ablation-related injuries

Hamid Bastani*, Per Insulander, Jonas Schwieler, 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 as an alternative to radio frequency (RF) ablation in high-risk-located atrial tachycardia (AT).

Methods and results: Between 2004 and 2007, 164 patients underwent catheter ablation due to AT at our institution. Twenty-six of these patients (22 women and 4 men), median age 58 years (range 14–76), were considered having high-risk-located AT and were treated by cryoablation. Seven patients had failed prior RF ablation due to high risk of complications. The AT foci distribution was: close to the AV node (n = 14), vicinity of the sinus node (n = 7), and crista terminalis adjacent to the phrenic nerve (n = 5). Cryomapping, using a 6 mm tip catheter, at –30°C was performed before ablation with a goal temperature of –80°C for 240 s. Acute success rate was achieved in 25/26 patients (96%). During a follow-up of 493 ± 258 days, three patients had recurrences. Two of these underwent a second successful cryoablation procedure. Long-term success rate was 92%. Phrenic nerve palsy occurred in two patients with complete recovery after 1 day and 5 months, respectively.

Conclusion: Cryoablation of high-risk-located AT foci is a safe and effective alternative to RF therapy.

Key Words: Cryomapping, Cryoablation, Atrial tachycardia, High-risk location, Complication

* Corresponding author. Tel: +46 8 585 80000, Fax: +46 8 585 86710, Email: hamid.bastani{at}karolinska.se

Manuscript submitted 9 October 2008. Accepted after revision 22 December 2008.


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M. Jensen-Urstad, H. Bastani, F. Braunschweig, N. Drca, P. Insulander, G. Kenneback, J. Schwieler, and F. Tabrizi
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