Intracardiac ablation for atrioventricular nodal reentry tachycardia using a 6 mm distal electrode cryoablation catheter: Prospective, multicenter, North American study (ICY‐AVNRT STUDY)

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Excerpt

There are 89,000 new cases of supraventricular tachycardia (SVT) annually in the United States,1 and atrioventricular nodal reentrant tachycardia (AVNRT) is the most common mechanism.2 When treatment by catheter ablation is necessary, radiofrequency (RF) ablation is effective for slow pathway ablation but carries a risk of complete heart block necessitating permanent pacing.3 Cryothermal ablation offers the ability to test the efficacy and safety at a site before permanent lesion creation. Furthermore, it allows a stable catheter position due to adherence of the tip at the site of interest after a critically low temperature has been reached (cryoadherence).
The first cryocatheter approved by the FDA for slow pathway ablation with a 4‐mm distal electrode was safe but not as effective when compared with RF ablation.4 A cryocatheter with a 6‐mm distal electrode was developed with the goal of making larger lesions,5 and it was found to be more effective than the original.6 When these larger catheters were compared with RF ablation, acute efficacy was similar but recurrence rates were still higher8; however, the usage of a best practices methodology was not mandated in these studies. The ICY‐AVNRT study (NCT01426425) was undertaken to test the hypothesis that incorporating best practices would result in safety and efficacy similar to that reported with RF ablation.
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