Catheter-based cryoablation permanently cures patients with common atrial flutter

Article

关键词: RADIOFREQUENCY ABLATION;    ISTHMUS ABLATION;    CORONARY-ARTERY;    CONDUCTION;    BLOCK;    FIBRILLATION;    DOGS;    TIP;   

DOI  :  10.1161/01.CIR.0000124478.98343.00

来源: SCIE

【 摘 要 】

Background - Cryoablation (cryo) has a high success rate in the short-term treatment of atrial flutter (AFL), but evidence of long-term efficacy is lacking. The present study reports the long-term effect of cryo of the cavotricuspid isthmus (CTI) in patients with common AFL. Methods and Results - Thirty-five consecutive patients (28 men; mean age, 53 years) underwent cryo of the CTI. In 34 patients, the AFL had a counterclockwise rotation (cycle length, 242 +/- 43 ms). Eleven patients had structural heart disease. Cryo was performed with a 10F catheter with a 6-mm-tip electrode (CryoCor). Applications (3 to 5 minutes each) were delivered by use of a point-by-point technique to create the ablation line. The acute end point of the procedure was creation of bidirectional isthmus conduction block and noninducibility of AFL. A median of 14 applications (range, 4 to 30) at 10 sites (range, 4 to 19) was given along the CTI with a mean temperature of -80.0 +/- 5.0degreesC. Mean fluoroscopy and procedure times were 40 +/- 26 minutes and 3.2 +/- 1.3 hours, respectively. Of the 35 patients, 34 were acutely successfully ablated (97%). After a mean follow-up of 17.6 +/- 6.2 months (range, 9.6 to 26.1 months), 31 patients (89%) did not have recurrence of AFL. Three of the 4 patients with recurrence had a second successful procedure. One patient had transient ST elevation in the inferior leads during cryoapplication. Conclusions - Cryo produces permanent bidirectional isthmus conduction block of the CTI. Short- and long-term success rates are comparable to those for radiofrequency ablation.

【 授权许可】

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