A prospective randomised comparison of large-tip cryoablation and 8-mm-tip radiofrequency catheter ablation of atrial flutter.
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.
Malmborg
Helena
H
Department of Cardiology, Uppsala University Hospital, SE-751 85 Uppsala, Sweden. helena.malmborg@akademiska.se
Lönnerholm
Stefan
S
Lundqvist
Carina Blomström
CB
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