title: A prospective randomised comparison of large-tip cryoablation and 8-mm-tip radiofrequency catheter ablation of atrial flutter.
abstract: OBJECTIVE
  Although radiofrequency (RF) energy is routinely used for tricuspid isthmus (TI) ablation, it is often associated with discomfort. The paucity of studies comparing the feasibility and efficacy of cryo- versus RF energy for TI-ablation urged us to conduct a prospective, randomised trial.
  
  
  METHODS
  Forty patients with atrial flutter (AFl) were randomised to RF- or cryoenergy for TI-ablation. Perceived pain was scored from 1 to 10 on a Visual Analogue Scale.
  
  
  RESULTS
  Significantly lower pain scores were recorded for cryoablation versus RF ablation (0.96 +/- 0.73 versus 4.2 +/- 2.4, p = 0.00004). Cryoablation was associated with significantly longer procedure duration and ablation time (137 +/- 35 versus 111 +/- 29 min, p = 0.016 and 81 +/- 40 versus 48 +/- 30 min, p = 0.007) and lower acute success rate (56% versus 100%, p = 0.001) than RF ablation. The recurrence of AFl was 20% (cryo) versus 15% (RF; p = 0.45) after a mean of 15.1 months follow-up.
  
  
  CONCLUSIONS
  Cryoablation results in significantly less pain and discomfort compared to RF ablation of AFl, which is offset by the significantly lower acute success rate.
authors.affiliation: Department of Cardiology, Uppsala University Hospital, SE-751 85 Uppsala, Sweden. helena.malmborg@akademiska.se
authors.forename: Helena
authors.initials: H
authors.lastname: Malmborg
authors.forename: Stefan
authors.initials: S
authors.lastname: Lönnerholm
authors.forename: Carina Blomström
authors.initials: CB
authors.lastname: Lundqvist
mesh_terms: D000328:Adult; D000368:Aged; D001282:Atrial Flutter / Q000175:diagnosis / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods*; D003452:Cryosurgery / Q000295:instrumentation* / Q000379:methods*; D004566:Electrodes; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome