Details

Autor(en) / Beteiligte

• KUNISS, MALTE
• KURZIDIM, KLAUS
• GREISS, HARALD
• BERKOWITSCH, ALEXANDER
• SPERZEL, JOHANNES
• HAMM, CHRISTIAN
• PITSCHNER, HEINZ FRIEDRICH

Titel

Acute Success and Persistence of Bidirectional Conduction Block in the Cavotricuspid Isthmus One Month Post Cryocatheter Ablation of Common Atrial Flutter

Ist Teil von

• Pacing and clinical electrophysiology, 2006-02, Vol.29 (2), p.146-152

Ort / Verlag

350 Main Street , Malden , MA 02148-5018 , USA and 9600 Garsington Road , Oxford OX4 2DQ , UK: Blackwell Publishing Inc

Erscheinungsjahr

2006

Link zum Volltext

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Introduction: Cryoablation is successful in the treatment of common atrial flutter. Long‐term clinical success is mainly dependent on persistence of bidirectional conduction block (BCB) in the inferior cavotricuspid isthmus (CTI). Only few data on persistence of BCB post cryoablation with the reported technique are available. This prospective study aimed to test efficacy of cryo energy and persistence of BCB in the CTI 1 month post cryoablation. Methods: Cryoablation of the CTI was performed in 50 consecutive patients (64 ± 12 years, 40 males) with symptomatic common atrial flutter using a novel 9 Fr 8‐mm‐tip catheter. BCB in the CTI 30 minutes following the final cryoapplication was the ablation endpoint. Thirty days post ablation, persistence of BCB was controlled by repeat electrophysiological study (EPS). Results: In all patients BCB was achieved with a mean of 9 (IQR 7–17.5) cryo applications and a mean cryo time of 2,378 seconds (IQR 1,680–3,474 seconds). In 5 of 50 patients, common atrial flutter recurred within 1 month post cryoablation. In 30 of 32 recurrence‐free patients, persistence of BCB was verified. In 2 patients, resumption of isthmus conduction was detectable. Including relapses, 81.1% of patients (30/37) showed persistence of BCB. No patients reported pain during cryoapplication. No procedural complications were observed. Conclusions: Cryoablation of the CTI using a large‐tip catheter is feasible and safe in the treatment of common atrial flutter. Acute and short‐term success rates are comparable to those reported for radiofrequency (RF) ablation. Besides short‐term clinical success, the persistence of BCB demonstrates efficacy of the cryoablation technique.