Cryothermal ablation of typical atrial flutter

Objectives: To evaluate the efficacy and safety of cryoablation compared with the radiofrequency (RF) method in the treatment of typical atrial flutter (AFL). Methods: 12 patients with typical counterclockwise AFL underwent cryoablation of the cavotricuspid isthmus. Cryoablation was performed with a 9F catheter with an 8 mm tip electrode. Applications were delivered by point-by-point technique to create the ablation line. The end point of the procedure was achievement of bidirectional isthmus conduction block. Control group consisted of 12 consecutive patients who underwent the ablation by means of RF method. Results: We found no differences in the duration of transisthmic conduction after ablation in both groups and in the fluoroscopy time. We found significant differences in the procedural time (187 +/- 81 vs 110 +/- 35 minutes, p<0.01) and in the analgesic use (0/12 vs 12/12, p<0.01). After a 3 month follow-up all patients in both groups were free from the recurrence of AFL, 1 patient in cryoablation group had paroxysm of atrial fibrillation. Conclusions: Efficacy and safety profile of cryoablation are similiar with RF ablation. Procedural time in the cryoablation group is significantly longer but the use of analgesics can be completely avoided (Tab. 2, Ref. 20). Full Text (Free, PDF) www.bmj.sk.