Acute success and short-term follow-up of catheter ablation of isthmus-dependent atrial flutter; a comparison of 8 mm tip radiofrequency and cryothermy catheters
| Autor: | Max Miltenburg, Luc Jordaens, Joris Mekel, Marco Alings, Emile Jessurun, Andrew S. Thornton, Marcoen F. Scholten, Petter Janse |
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| Přispěvatelé: | Cardiology |
| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Cavotricuspid isthmus medicine.medical_treatment Catheter ablation Atrial flutter Cryosurgery Article Postoperative Complications Physiology (medical) Internal medicine medicine Humans cardiovascular diseases Fibrillation business.industry Atrial fibrillation Cryoablation Middle Aged medicine.disease Ablation Surgery Cryothermy Treatment Outcome Radiofrequency cardiovascular system Cardiology Catheter Ablation Female medicine.symptom Cardiology and Cardiovascular Medicine business Arrhythmia Follow-Up Studies |
| Zdroj: | Journal of Interventional Cardiac Electrophysiology Journal of Interventional Cardiac Electrophysiology, 21(3), 241-248. Springer Netherlands |
| ISSN: | 1383-875X |
| Popis: | Objectives To compare the acute success and short-term follow-up of ablation of atrial flutter using 8 mm tip radiofrequency (RF) and cryocatheters. Methods Sixty-two patients with atrial flutter were randomized to RF or cryocatheter (cryo) ablation. Right atrial angiography was performed to assess the isthmus. End point was bidirectional isthmus block on multiple criteria. A pain score was used and the analgesics were recorded. Patients were followed for at least 3 months. Results The acute success rate for RF was 83% vs 69% for cryo (NS). Procedure times were similar (mean 144 +/- 48 min for RF, vs 158 +/- 49 min for cryo). More applications were given with RF than with cryo (26 +/- 17 vs. 18 +/- 10, p +/- 0.05). Fluoroscopy time was longer with RF (29 +/- 15 vs. 19 +/- 12 min, p +/- 0.02). Peak CK, CK-MB and CK-MB mass were higher, also after 24 h in the cryo group. Troponin T did not differ. Repeated transient block during application (usually with cryoablation) seemed to predict failure. Cryothermy required significantly less analgesia (p +/- 0.01), and no use of long sheaths (p +/- 0.005). The isthmus tended to be longer in the failed procedures (p +/- 0.117). This was similar for both groups, as was the distribution of anatomic variations. Recurrences and complaints in the successful patients were similar for both groups, with a very low recurrence of atrial flutter after initial success. Conclusions In this randomized study there was no statistical difference but a trend to less favorable outcome with 8 mm tip cryocatheters compared to RF catheters for atrial flutter ablation. Cryoablation was associated with less discomfort, fewer applications, shorter fluoroscopy times and similar procedure times. The recurrence rate was very low. Cryotherapy can be considered for atrial flutter ablation under certain circumstances especially when it has been used previously in the same patient, such as in an AF ablation. |
| Databáze: | OpenAIRE |
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