title: Comparison of a 6.5, 10, and 15 mm cryoablation catheter-tip for the treatment of common atrial flutter.
abstract: OBJECTIVE
  Only a few studies have investigated the effect of large tip sizes for catheter-based cryoablation (cryo). This study evaluates the safety and efficacy of cryo of the cavotricuspid isthmus (CTI) using three cryocatheter-tip sizes.
  
  
  RESULTS
  Forty-five consecutive patients with common atrial flutter (AFL) underwent cryo of the CTI using a 6.5, a 10, or a novel 15 mm catheter-tip. Single applications of 3 min were delivered at each site along the CTI. Baseline characteristics of the three groups were comparable. The overall acute success rate was 89% and there was no difference with respect to the tip electrode size (P > 0.05). Fewer applications were required for a 10 mm (6 ± 2, range 3-7) and a 15 mm (6 ± 1, range 4-8) compared with a 6.5 mm catheter-tip (8 ± 3, range 4-14; P < 0.05). Procedure time was significantly shorter with the largest tip electrode (89 ± 26 min vs. 132 ± 28 min (6.5 mm tip), P < 0.05). No complications occurred. After a mean follow-up of 51 ± 5 months, 43 patients (96%) were without recurrence of AFL.
  
  
  CONCLUSIONS
  A large (10 or 15 mm) cryoablation catheter-tip requires significantly fewer applications to create bidirectional CTI block compared with a 6.5 mm tip. A significant decrease in procedure time with preservation of the overall safety and efficacy supports the preference of a 15 over a 6.5 mm catheter-tip for cryoablation of AFL.
authors.affiliation: Department of Cardiology, Academic Hospital Maastricht and Cardiovascular Research Institute, Maastricht, CARIM, PO Box 5800, AZ 6202 Maastricht, The Netherlands.
authors.forename: Randy
authors.initials: R
authors.lastname: Manusama
authors.forename: Carl
authors.initials: C
authors.lastname: Timmermans
authors.forename: Maud
authors.initials: M
authors.lastname: van der Schoot
authors.forename: Suzanne
authors.initials: S
authors.lastname: Philippens
authors.forename: Luz-Maria
authors.initials: LM
authors.lastname: Rodriguez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001282:Atrial Flutter / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D062906:Cardiac Catheters; D016009:Chi-Square Distribution; D003452:Cryosurgery / Q000009:adverse effects / Q000295:instrumentation*; D022062:Electrophysiologic Techniques, Cardiac; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult