title: Performance of a new cardiac cryoablation system in the treatment of cavotricuspid valve isthmus-dependent atrial flutter.
abstract: We sought to evaluate prospectively the safety and efficacy of cryothermal energy to ablate typical atrial flutter (AFL). Ablation of cardiac tissue using cryothermal energy has recently been developed as an alternative to radiofrequency energy, which may offer certain advantages in the treatment of AFL. This prospective, multicenter nonrandomized study of a new catheter-based system for the treatment of cavotricuspid isthmus (CTI)-dependent AFL enrolled patients between 18 and 75 years of age. The CTI dependence of AFL was confirmed at electrophysiologic study with activation mapping and/or entrainment. Patients with atrial septal defect, recent myocardial infarction, left ventricular ejection fraction <0.30, or prior AFL ablation were excluded. Cryoablation of AFL was performed in 48 patients from 11 centers. The procedure was immediately successful in 45 patients (94%), and effective in 30 of 40 patients with complete data available at 6 months. Cryoablation is a promising new treatment of CTI-dependent AFL refractory to medical therapy. Further improvements in catheter design and intravascular sheaths will be tested in a larger multicenter trial.
authors.affiliation: Cardiology Unit, Department of Medicine, University of Rochester Medical Center, Rochester, New York 14642-8679, USA. James_Daubert@URMC.Rochester.edu
authors.forename: James P
authors.initials: JP
authors.lastname: Daubert
authors.forename: Robert H
authors.initials: RH
authors.lastname: Hoyt
authors.forename: Roy
authors.initials: R
authors.lastname: John
authors.forename: Larry
authors.initials: L
authors.lastname: Chinitz
authors.forename: David T
authors.initials: DT
authors.lastname: Martin
authors.forename: Christopher
authors.initials: C
authors.lastname: Fellows
authors.forename: Gregory
authors.initials: G
authors.lastname: Feld
authors.forename: William
authors.initials: W
authors.lastname: Pelkey
authors.forename: Ruchir
authors.initials: R
authors.lastname: Sehra
mesh_terms: D001282:Atrial Flutter / Q000209:etiology / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation; D003452:Cryosurgery / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014261:Tricuspid Valve; D014682:Vena Cava, Inferior