Cryoablation as standard treatment of atrial flutter: a prospective, 2-center study (CASTAF)
| Autor: | Bita Sadigh, Jari Tapanainen, Kristjan Gudmundsson, Frieder Braunschweig, Ott Saluveer, Per Insulander, Anette Jemtrén, Hamid Bastani, Mats Jensen-Urstad, Jonas Schwieler, Nikola Drca, S. Scheel, E. Ljungstrom, Göran Kennebäck, Tara Bourke |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Cavotricuspid isthmus animal structures Radiofrequency ablation medicine.medical_treatment 030204 cardiovascular system & hematology Cryosurgery law.invention 03 medical and health sciences 0302 clinical medicine law Recurrence Medicine Humans cardiovascular diseases 030212 general & internal medicine Prospective Studies Aged Aged 80 and over business.industry Standard treatment Cryoablation General Medicine Middle Aged Ablation medicine.disease Treatment Outcome Atrial Flutter cardiovascular system Catheter Ablation Radiology Cardiology and Cardiovascular Medicine business Atrial flutter |
| Zdroj: | Acta cardiologica. 76(3) |
| ISSN: | 1784-973X |
| Popis: | Cryoablation (CRYO) of cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) has been shown to be non-inferior to radiofrequency ablation (RF) in terms of ablation success and is associated with less pain. However, procedural time has been significantly longer with CRYO compared to RF. A possible explanation for this could be that operators had less experience with CRYO than with RF. The purpose of this study was to test the hypothesis that in the hands of experienced operators, cryoablation of CTI-dependent AFL is effective with procedure-time similar to what is reported for RF.This prospective 2-center study included 184 patients with CTI-dependent AFL - median age 66 years (range 28-83), 159 men (86%). Cryoablation was performed using a 9 F, 8 mm tip catheter (Freezor MAX, Medtronic, Inc, MN, USA). Ablation endpoint was bidirectional CTI-block. Pain was evaluated with a visual analogue scale (VAS 0-10). All operators had experience of at least 25 previous CTI-ablations with CRYO.The acute success rate was 89%. Procedural time including an observation period of 30 min, was 115 ± 36 min which is similar to procedural times for RF in previous studies. Fluoroscopy time was 11 ± 9 min. Cryoablation was perceived as almost pain- free by the patients, VAS (mean) 1.8 ± 1.2. Success rate at 12-month follow-up (FU) was 88% in patients with primary success. No major adverse events occurred.Cryoablation of CTI-dependent AFL is effective, with a low level of procedure-related pain. In experienced hands, the procedure time in this prospective non-randomised trial seems to be in the level of reported procedure times for RF. The long-term relapse rate appears to be higher than for RF. |
| Databáze: | OpenAIRE |
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