Published in:
01-09-2020 | Atrioventricular Block
Japan ablation registry: cryoablation in atrioventricular nodal reentrant tachycardia (“JARCANRET study”): results from large multicenter retrospective investigation
Authors:
Kaoru Okishige, Ken Okumura, Takuo Tsurugi, Akihiko Yotsukura, Tadafumi Nanbu, Hirotaka Sugiura, Akiko Sanada, Yusuke Kondo, Masahiro Takano, Takehiko Keida, Masaki Fujita, Hiroki Kamiya, Kunihiko Tsuchiya, Kazumasa Adachi, Yukinori Katoh, Kenichi Hiroshima, Kei Yamamoto, Keiichi Ashikaga, Tadashi Hoshiyama, Tetsuo Sasano, Kenzo Hirao
Published in:
Journal of Interventional Cardiac Electrophysiology
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Issue 3/2020
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Abstract
Purpose
Cryoenergy has been demonstrated to be a safe alternative to radiofrequency ablation for catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT). This study aimed to evaluate the safety and efficacy of cryoablation in patients with AVNRT.
Methods
A multicenter retrospective study was performed. Two hundred eighty-three consecutive patients with AVNRT underwent cryoablation. Cryomapping at − 30 °C and − 80 °C was performed to predict cryoablation outcome and ascertain antegrade conduction. Cryoenergy was delivered subsequently at the same spot (cryoablation at − 80 °C) for 240 s.
Results
Ablation procedure was acutely successful in 281 out of 283 patients (99.3%). Of note, 22 patients (10.1%) had transient AV block during the cryoablation, but no injurious effects on AV conduction were provoked during cryomapping. During a follow-up period of 367 ± 35 days, the recurrence rate was 3.9% (11 out of 281). There were no significant differences among the patients with a complete elimination of slow pathway conduction, AH jump without an echo beat, and AH jump with a single echo beat, in terms of the long-term recurrence of AVNRT.
Conclusions
Cryoablation of AVNRT appears to be effective both acutely and during the long-term with a minimal risk of unwanted injuries to the conduction system. It seems to be important to monitor the antegrade conduction during cryoenergy applications, even when cryomapping demonstrates a safe location for cryoablation. The recurrence rate of AVNRT did not differ according to the properties of the residual slow pathway conduction.