Time-limited cryomapping during tachycardia: improved long-term outcomes for cryoablation of AVNRTReportar como inadecuado




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Journal of Interventional Cardiac Electrophysiology

, Volume 47, Issue 1, pp 125–131

First Online: 25 May 2016Received: 10 March 2016Accepted: 16 May 2016

Abstract

PurposeCryothermal ablation CTA for atrioventricular nodal reentrant tachycardia AVNRT is considered safer than radiofrequency ablation RFA since it eliminates the risk of inadvertent AV block. However, it has not been widely adopted due to high late recurrence rate LRR. In an effort to improve LRR, we evaluated a new approach to cryothermal mapping CTM: -time to tachycardia termination- TTT.

MethodsThis single-center study had 88 consecutive patients who underwent CTA using TTT for AVNRT. The CTA catheter was positioned in sinus rhythm at the posteroseptal tricuspid annulus, and then AVNRT was induced. The CTA target site was identified by prompt tachycardia termination in ≤20 s during CTM. Procedural success was defined as no inducible AVNRT and ≤1 single AV nodal echoes.

ResultsAcute procedural success was achieved in 87 of 88 patients 98.9 % and was similar to prior studies for both CTA and RFA. No permanent AV block was observed. LRR was 3.7 % at a mean follow-up of 19.7 months. LRR was equivalent to that commonly reported for RFA and improved when compared to conventional CTA.

ConclusionTTT for CTA of AVNRT provides enhanced safety and similar long-term efficacy when compared to RFA. Based upon this experience, TTT provides an enhancement to conventional CTA that appears to result in improved long-term outcomes. In light of these findings, it seems reasonable to undertake additional randomized trials to determine whether RFA or CTA using TTT is the optimal approach for the catheter ablation of AVNRT.

KeywordsAVNRT Cryoablation Cryomapping Time to effect Time to tachycardia termination AbbreviationsTTTTime to tachycardia termination

TTETime to effect

AVNRTAtrioventricular nodal reentry tachycardia

SPSlow pathway

RFARadiofrequency ablation

EAMElectro-anatomic mapping

CTACryothermal ablation

CTMCryothermal mapping

LRRLate recurrence rate

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Autor: Paula L. S. Eryazici - Mansour Razminia - Oliver D’Silva - Jaime R. Chavez - Ferah D. Ciftci - Marianne Turner - Theod

Fuente: https://link.springer.com/







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