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Very long‐term outcomes after catheter ablation of atrioventricular nodal reentrant tachycardia: How does cryoenergy differ from radiofrequency?
Author(s) -
Chaumont Corentin,
Mirolo Adrian,
Savouré Arnaud,
Godin Bénédicte,
Auquier Nathanaël,
Viart Guillaume,
Hatrel Amandine,
Gillibert André,
Eltchaninoff Hélène,
Anselme Frédéric
Publication year - 2020
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14784
Subject(s) - medicine , tachycardia , radiofrequency ablation , ablation , cryoablation , confidence interval , catheter ablation , atrioventricular block , odds ratio , hazard ratio , cardiology , population , surgery , environmental health
Either cryoenergy or radiofrequency can be used during atrioventricular nodal reentrant tachycardia (AVNRT) ablation. There are still limited data comparing their respective long‐term efficacy (>1 year). This study sought to compare the very long‐term outcomes of AVNRT ablation using radiofrequency or cryotherapy. Methods We retrospectively included all patients who had undergone a first AVNRT ablation in our institution between January 2010 and December 2017. The primary endpoint was recurrence of documented AVNRT. Results The study population consisted of 409 patients (274 females; mean age, 49.9 years). Ablation was performed using cryoenergy in 260 patients and radiofrequency in 149. High acute procedural success rate (>98%) was obtained and no permanent AV block was observed using both techniques. During a mean follow‐up of 3.3 ± 2.3 years, documented AVNRT recurrence occurred in 24 (9.2%) and 4 patients (2.7%) in the cryoablation (CA) and radiofrequency (RF) group, respectively. The risk of AVNRT recurrence was significantly higher in the CA group as compared with the RF group (hazard ratio [HR] = 3.7; 95% confidence interval [CI], 1.3–5.9). Most of the recurrences after CA occurred between 1‐ and 6‐year follow‐up (14/24; 58.3%), with one‐third of late recurrences after 3‐year follow‐up. In multivariable analysis, only Koch's triangle anatomical variant was associated with AVNRT recurrence after CA (HR = 6.7; 95% CI, 2.7–16.3). Conclusion While AVNRT recurrence rates were similar at 1 year of follow‐up regardless of the energy used, long‐term efficacy appeared higher after radiofrequency ablation. Strikingly, recurrences occured much later after cryotherapy compared with radiofrequency ablation.