Cryoablation versus radiofrequency ablation for treatment of atrioventricular nodal reentrant tachycardia: Cryoablation with 6-mm-tip catheters is still less effective than radiofrequency ablation

BACKGROUND The treatment of choice for atrioventricular nodal reentrant tachycardia (AVNRT) is catheter ablation of the atrioventricular nodal slow pathway. OBJECTIVE The purpose of this study was to ascertain whether cryoablation (Cryo) with 6-mm-tip catheters is as effective as radiofrequency ablation (RF). METHODS Patients who had catheter ablation for AVNRT between 2005 and 2008 were identified. The main outcome measure was overall success without the use of an alternative energy source and no recurrence. RESULTS Two hundred eighty-eight procedures in 272 patients were identified; 184 were female (68%), and the mean age was 53 +/- 14 (17-88) years. There were 123 Cryo and 149 RF procedures. Cryo had a lower overall success rate (83% vs. 93%; P = .02). Mean procedure times were similar in both groups (90 minutes; P = .5). Fluoroscopy time was longer with Cryo: 16 (7-48) versus 14 (5-50) minutes (P = .04). Only one case of atrioventricular block was observed in the RF group (0.7%). Cryo was more expensive than RF (3141 pound vs. 2153) pound. CONCLUSION Even when delivering multiple lesions with 6-mm-tip catheters, Cryo is less effective than RF. RF is recommended as a first-line treatment, although the only major complication occurred in the RF group.