Cryoablation versus radiofrequency ablation for atrioventricular nodal reentrant tachycardia: patient pain perception and operator stress.
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.
Chan
Ngai Yin
NY
Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong. ngaiyinchan@yahoo.com.hk
Choy
Chi Chung
CC
Lau
Chun Leung
CL
Lo
Ying Keung
YK
Chu
Pui Shan
PS
Yuen
Ho Chuen
HC
Choi
Yuen Choi
YC
Lau
Suet Ting
ST
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