Very long‐term outcomes after catheter ablation of atrioventricular nodal reentrant tachycardia: How does cryoenergy differ from radiofrequency?. (11th November 2020)

• Record Type: Journal Article
• Authors: Chaumont, Corentin; Mirolo, Adrian; Savouré, Arnaud; Godin, Bénédicte; Auquier, Nathanaël; Viart, Guillaume; Hatrel, Amandine; Gillibert, André; Eltchaninoff, Hélène; Anselme, Frédéric
• Is Part Of: Journal of cardiovascular electrophysiology. Volume 31:Number 12(2020)
• Page Start: 3215
• Page End: 3222
• Publication Date: 2020-11-11
• Subjects: AVNRT -- clinical outcomes -- cryoablation -- radiofrequency; Blood vessels -- Physiology -- Periodicals; Electrophysiology -- Periodicals; Heart -- Physiology -- Periodicals; 612.1
• DOI: 10.1111/jce.14784
• Languages: English
• ISSNs: 1045-3873

Abstract

Abstract: Introduction: Either cryoenergy or radiofrequency can be used during atrioventricular nodal reentrant tachycardia (AVNRT) ablation. There are still limited data comparing their respective long‐term efficacy (>1 year). This study sought to compare the very long‐term outcomes of AVNRT ablation using radiofrequency or cryotherapy. Methods: We retrospectively included all patients who had undergone a first AVNRT ablation in our institution between January 2010 and December 2017. The primary endpoint was recurrence of documented AVNRT. Results: The study population consisted of 409 patients (274 females; mean age, 49.9 years). Ablation was performed using cryoenergy in 260 patients and radiofrequency in 149. High acute procedural success rate (>98%) was obtained and no permanent AV block was observed using both techniques. During a mean follow‐up of 3.3 ± 2.3 years, documented AVNRT recurrence occurred in 24 (9.2%) and 4 patients (2.7%) in the cryoablation (CA) and radiofrequency (RF) group, respectively. The risk of AVNRT recurrence was significantly higher in the CA group as compared with the RF group (hazard ratio [HR] = 3.7; 95% confidence interval [CI], 1.3–5.9). Most of the recurrences after CA occurred between 1‐ and 6‐year follow‐up (14/24; 58.3%), with one‐third of late recurrences after 3‐year follow‐up. In multivariable analysis, only Koch's triangle anatomical variant was associated with AVNRT recurrence after CA (HR = 6.7; 95% CI, 2.7–16.3). Conclusion: While AVNRT recurrence rates were similar at 1 year of follow‐up regardless of the energy used, long‐term efficacy appeared higher after radiofrequency ablation. Strikingly, recurrences occured much later after cryotherapy compared with radiofrequency ablation.