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. 2021 Nov;32(11):2971-2978.
doi: 10.1111/jce.15244. Epub 2021 Sep 22.

Cryoablation of atypical atrioventricular nodal reentry tachycardia

Gesa von Olshausen  1 , Anette Jemtrén  2   3 , Jonas Schwieler  1 , Jari Tapanainen  1 , Tara Bourke  1 , Astrid Paul-Nordin  1   2 , Lina Benson  4 , Ott Saluveer  1 , Göran Kennebäck  1 , Frieder Braunschweig  1   4 , Nikola Drca  1   2
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Cryoablation of atypical atrioventricular nodal reentry tachycardia

Gesa von Olshausen et al. J Cardiovasc Electrophysiol. 2021 Nov.

Abstract

Aim: Data on ablation for atypical recurrent atrioventricular nodal reentry tachycardia (AVNRT) and long-term follow-up are generally sparse. Furthermore, the rate of recurrence and safety of cryoablation for atypical AVNRT has not been established. We compared patients cryoablated for atypical AVNRT and typical AVNRT during long-term follow-up.

Methods: All patients (n = 2612) who underwent catheter ablation for AVNRT at the Karolinska University Hospital between January 2009 and August 2019 were analyzed. A total of 91 patients undergoing first-time cryoablation for atypical AVNRT were included. A control group with first-time cryoablation for typical AVNRT was matched in a 1:1 ratio. Patients were followed-up for recurrences for a median of 5.0 years (interquartile range: 3.1-7.5 years).

Results: After 5 years, AVNRT recurrence occurred in 10 patients (11.0%) in the atypical AVNRT group and in 8 patients (8.8%) in the typical AVNRT group (hazard ratio: 1.31 [95% confidence interval: 0.52-3.32]; p = 0.568). The duration of the index procedure was significantly longer for atypical compared to typical AVNRT ablation (132.1 ± 49.2 min vs. 110.1 ± 38.8 min; p = 0.001). Transient AV blocks occurred in a similar fashion in the atypical compared to typical group (11 [12.1%] vs. 4 [4.9%]; p = 0.103). However, no ablation induced persistent AV block developed in either group.

Conclusion: Cryoablation for atypical AVNRT showed similar rate of recurrences and safety compared to typical AVNRT during long-term follow-up.

Keywords: atypical atrioventricular nodal reentry tachycardia; cardiac electrophysiology; cryoablation.

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References

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