Cryoablation versus radiofrequency energy for the ablation of atrioventricular nodal reentrant tachycardia (the CYRANO Study): results from a large multicenter prospective randomized trial.

Deisenhofer, I; Zrenner, B; Yin, YH; Pitschner, HF; Kuniss, M; Grossmann, G; Stiller, S; Luik, A; Veltmann, C; Frank, J; Linner, J; Estner, HL; Pflaumer, A; Wu, J; von Bary, C; Ucer, E; Reents, T; Tzeis, S; Fichtner, S; Kathan, S; Karch, MR; Jilek, C; Ammar, S; Kolb, C; Liu, ZC; Haller, B; Schmitt, C; Hessling, G

doi:10.1161/CIRCULATIONAHA.110.970350

journal article

Titel:: Cryoablation versus radiofrequency energy for the ablation of atrioventricular nodal reentrant tachycardia (the CYRANO Study): results from a large multicenter prospective randomized trial.
Dokumenttyp:: Journal Article; Multicenter Study; Randomized Controlled Trial; nicht gelistet
Autor(en):: Deisenhofer, I; Zrenner, B; Yin, YH; Pitschner, HF; Kuniss, M; Grossmann, G; Stiller, S; Luik, A; Veltmann, C; Frank, J; Linner, J; Estner, HL; Pflaumer, A; Wu, J; von Bary, C; Ucer, E; Reents, T; Tzeis, S; Fichtner, S; Kathan, S; Karch, MR; Jilek, C; Ammar, S; Kolb, C; Liu, ZC; Haller, B; Schmitt, C; Hessling, G
Abstract:: Cryoablation has emerged as an alternative to radiofrequency catheter ablation (RFCA) for the treatment of atrioventricular (AV) nodal reentrant tachycardia (AVNRT). The purpose of this prospective randomized study was to test whether cryoablation is as effective as RFCA during both short-term and long-term follow-up with a lower risk of permanent AV block.A total of 509 patients underwent slow pathway cryoablation (n=251) or RFCA (n=258). The primary end point was immediate ablation failure, permanent AV block, and AVNRT recurrence during a 6-month follow-up. Secondary end points included procedural parameters, device functionality, and pain perception. Significantly more patients in the cryoablation group than the RFCA group reached the primary end point (12.6% versus 6.3%; P=0.018). Whereas immediate ablation success (96.8% versus 98.4%) and occurrence of permanent AV block (0% versus 0.4%) did not differ, AVNRT recurrence was significantly more frequent in the cryoablation group (9.4% versus 4.4%; P=0.029). In the cryoablation group, procedure duration was longer (138±54 versus 123±48 minutes; P=0.0012) and more device problems occurred (13 versus 2 patients; P=0.033). Pain perception was lower in the cryoablation group (P<0.001).Cryoablation for AVNRT is as effective as RFCA over the short term but is associated with a higher recurrence rate at the 6-month follow-up. The risk of permanent AV block does not differ significantly between cryoablation and RFCA. The potential benefits of cryoenergy relative to ablation safety and pain perception are counterbalanced by longer procedure times, more device problems, and a high recurrence rate.URL: http://www.clinicaltrials.gov. Unique identifier: NCT00196222.
Zeitschriftentitel:: Circulation
Jahr:: 2010
Band / Volume:: 122
Heft / Issue:: 22
Seitenangaben Beitrag:: 2239-45
Sprache:: eng
Volltext / DOI:: doi:10.1161/CIRCULATIONAHA.110.970350
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/21098435
Print-ISSN:: 0009-7322
TUM Einrichtung:: I. Medizinische Klinik und Poliklinik (Kardiologie); Institut für Medizinische Statistik und Epidemiologie; Klinik für Kinderkardiologie und angeborene Herzfehler (Prof. Hess)
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