title: Cryoablation versus radiofrequency ablation for atrioventricular nodal reentrant tachycardia: patient pain perception and operator stress.
abstract: BACKGROUND
  Cryoablation (CRYO) is an alternative to radiofrequency (RF) ablation in the treatment of atrioventricular nodal reentrant tachycardia (AVNRT). This study aims to evaluate the differences in patient pain perception and operator stress between CRYO and RF ablation in the treatment of AVNRT.
  
  
  METHODS
  Patients with supraventricular tachycardia underwent electrophysiology study. Twenty patients (eight males, age 46.5 ± 12.5 years) diagnosed with AVNRT were randomized to receive CRYO (11) with a 6-mm-tip catheter or RF (nine) with a 4-mm-tip catheter. Patients' pain perception and operator stress were assessed with a visual analogue scale (VAS) from 0 to 10 at the end of procedure.
  
  
  RESULTS
  There was no significant difference in acute procedural success (CRYO 100% vs RF 89%, P = 0.257). There was no complication of permanent atrioventricular block in either group. The number of energy applications was significantly higher in the CRYO group (2.8 ± 1.2 vs 1.6 ± 0.9, P = 0.02). The fluoroscopic time was significantly reduced in the CRYO group (6.0 ± 4.9 vs 10.9 ± 5.4 minutes, P = 0.049) with no difference in procedure time (CRYO 49.3 ± 12.5 vs RF 54.5 ± 17.0 minutes, P = 0.462). Patients in the CRYO group experienced significantly less pain than patients in the RF group (VAS 2.3 ± 2.8 vs 5.4 ± 3.4, P = 0.024). The operator also experienced significantly less stress during CRYO than RF (VAS 1.9 ± 0.8 vs 6.2 ± 1.6, P < 0.001). There was no recurrence in both groups at 6-month follow-up.
  
  
  CONCLUSIONS
  CRYO, as compared with RF, produces less pain in patients and less stress in operator in the treatment of AVNRT.
authors: Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong. ngaiyinchan@yahoo.com.hk
authors: Ngai Yin
authors: NY
authors: Chan
authors: Chi Chung
authors: CC
authors: Choy
authors: Chun Leung
authors: CL
authors: Lau
authors: Ying Keung
authors: YK
authors: Lo
authors: Pui Shan
authors: PS
authors: Chu
authors: Ho Chuen
authors: HC
authors: Yuen
authors: Yuen Choi
authors: YC
authors: Choi
authors: Suet Ting
authors: ST
authors: Lau
mesh_terms: D017115:Catheter Ablation / Q000009:adverse effects*; D003452:Cryosurgery / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology* / Q000517:prevention & control; D010820:Physicians / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology*; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000601:surgery*; D016896:Treatment Outcome