Document Detail


Cryoablation outcomes for AV nodal reentrant tachycardia comparing 4-mm versus 6-mm electrode-tip catheters.
MedLine Citation:
PMID:  18242545     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cryoablation is increasingly used to treat atrioventricular nodal reentrant tachycardia (AVNRT). It is unknown whether larger electrode-tip cryocatheters improve outcomes without compromising safety. OBJECTIVE: This study sought to compare acute and long-term success with 4-mm versus 6-mm electrode-tip cryocatheters for AVNRT. METHODS: We conducted a 2-group cohort study on 289 patients, age 45.5 +/- 15.9 years (76.8% female), who underwent transcatheter cryoablation as a first-time procedure for AVNRT with 4-mm (N = 152) or 6-mm (N = 137) electrode-tip catheters. RESULTS: Acute procedural success was achieved in 90.7% (95% confidence interval 86.9% to 93.7%) with no difference between the 2 electrode-tip sizes. A shorter fluoroscopy time (16.1 +/- 11.3 versus 20.3 +/- 14.9 minutes, P = .0096) and trend toward briefer procedural duration (166.6 +/- 49.1 versus 173.5 +/- 53.0 minutes, P = NS) were noted with 6-mm electrode tips. Transient AV block occurred in 5.2%, with complete recovery in 4.4 +/- 2.6 seconds. Over a median follow-up of 155 days, recurrences were less common with 6-mm electrode tips. Actuarial event-free survival rates at 1, 3, 6, and 12 months with 6-mm versus 4-mm electrode-tip cryocatheters were 96.7%, 93.4%, 91.9%, and 88.5% versus 89.9%, 87.0%, 84.1%, and 77.1%, respectively, with no recurrence thereafter (P = .0457). In multivariate analyses adjusting for baseline imbalances and medical therapy postablation, cryoablation with a 4-mm-tip catheter incurred a 2.5-fold increased risk of recurrence (hazard ratio 2.5, 95% confidence interval 1.0 to 6.1, P = .0420). CONCLUSION: In patients with AVNRT, cryoablation with 6-mm electrode-tip catheters is safe and is associated with fewer recurrences on long-term follow-up compared with 4-mm electrode-tip cryocatheters.
Authors:
Lena Rivard; Marc Dubuc; Peter G Guerra; Paul Novak; Denis Roy; Laurent Macle; Bernard Thibault; Mario Talajic; Paul Khairy
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-10-09
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  5     ISSN:  1547-5271     ISO Abbreviation:  Heart Rhythm     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-04     Completed Date:  2008-04-29     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  230-4     Citation Subset:  IM    
Affiliation:
Electrophysiology Service, Montreal Heart Institute, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Atrioventricular Node / physiopathology*
Cryosurgery / instrumentation*
Electrodes*
Equipment Design
Female
Humans
Male
Middle Aged
Prospective Studies
Recurrence
Research Design
Risk Factors
Tachycardia, Atrioventricular Nodal Reentry / mortality,  surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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