Cryoablation versus Radiofrequency Ablation for Atrioventricular Nodal Reentrant Tachycardia: Patient Pain Perception and Operator Stress

Methods: Patients with supraventricular tachycardia underwent electrophysiology study. Twenty patients (eight males, age 46.5 +/- 12.5 years) diagnosed with AVNRT were randomized to receive CRYO (11) with a 6-mm-tip catheter or RF (nine) with a 4-mm-tip catheter. Patients' pain perception and operator stress were assessed with a visual analogue scale (VAS) from 0 to 10 at the end of procedure. Results: There was no significant difference in acute procedural success (CRYO 100% vs RF 89%, P = 0.257). There was no complication of permanent atrioventricular block in either group. The number of energy applications was significantly higher in the CRYO group (2.8 +/- 1.2 vs 1.6 +/- 0.9, P = 0.02). The fluoroscopic time was significantly reduced in the CRYO group (6.0 +/- 4.9 vs 10.9 +/- 5.4 minutes, P = 0.049) with no difference in procedure time (CRYO 49.3 +/- 12.5 vs RF 54.5 +/- 17.0 minutes, P = 0.462). Patients in the CRYO group experienced significantly less pain than patients in the RF group (VAS 2.3 +/- 2.8 vs 5.4 +/- 3.4, P = 0.024). The operator also experienced significantly less stress during CRYO than RF (VAS 1.9 +/- 0.8 vs 6.2 +/- 1.6, P < 0.001). There was no recurrence in both groups at 6-month follow-up. Conclusions: CRYO, as compared with RF, produces less pain in patients and less stress in operator in the treatment of AVNRT. (PACE 2011; 2-7).