Catheter cryoablation of supraventricular tachycardia: Results of the multicenter prospective "frosty" trial

Peter L. Friedman, Marc Dubuc, Martin S. Green, Warren M. Jackman, David T J Keane, Roger A. Marinchak, Jose Nazari, Douglas L Packer, Allan Skanes, Jonathan S. Steinberg, William G. Stevenson, Patrick J. Tchou, David J. Wilber, Seth J. Worley

Research output: Contribution to journalArticle

149 Citations (Scopus)

Abstract

Objective. To study the safety, efficacy, and mapping utility of a new cryoablation catheter. Background: The CryoCath Technologies Freezor catheter has been used successfully for cryoablation of supraventricular tachycardia (SVT), but has not been evaluated in a large clinical trial. Methods: A multicenter clinical trial to evaluate the safety, efficacy, and cryomapping utility of this cryoablation catheter was conducted in 166 subjects. The target of ablation was the slow pathway in patients with SVT due to AV nodal reentry (AVNRT, n = 103), an accessory pathway in patients with AV reentrant SVT (AVRT, n = 51) and the AV junction in patients with atrial fibrillation (AF, n = 12). Results: Acute procedural success (APS) was achieved in 83% of the overall group (95% CI, 76% to 88%). APS in the AVNRT group was 91% (98.3% CI, 82% to 97%), compared to 69% for AVRT (98.3% CI, 51% to 84%) and 67% for AF (98.3% CI, 29% to 93%), a highly significant difference (P < .001 by stepwise logistic regression). In patients with APS, long-term success after 6 months was 91% overall (95% CI, 86% to 96%) and 94% for AVNRT subjects (98.3% CI, 87% to 100%). None of the AVNRT or AVRT subjects required a permanent pacemaker. Cryomapping successfully identified ablation targets in 64% of patients in whom it was attempted. The electrophysiologic effects of cryomapping were completely reversible within minutes in 94% of such attempts. Conclusions: Catheter cryoablation of SVT is a safe alternative to RF ablation and is clinically effective in patients with AVNRT. Cryomapping can reversibly identify targets for ablation and can help minimize the risk of inadvertent AV block during ablation.

Original languageEnglish (US)
Pages (from-to)129-138
Number of pages10
JournalHeart Rhythm
Volume1
Issue number2
DOIs
StatePublished - Jul 2004

Fingerprint

Cryosurgery
Supraventricular Tachycardia
Catheters
Clinical Trials
Safety
Atrioventricular Block
Atrial Fibrillation
Multicenter Studies
Logistic Models
Technology

Keywords

  • Atrioventricular node
  • Catheter ablation
  • Mapping
  • Tachycardia
  • Wolff-Parkinson-White syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Friedman, P. L., Dubuc, M., Green, M. S., Jackman, W. M., Keane, D. T. J., Marinchak, R. A., ... Worley, S. J. (2004). Catheter cryoablation of supraventricular tachycardia: Results of the multicenter prospective "frosty" trial. Heart Rhythm, 1(2), 129-138. https://doi.org/10.1016/j.hrthm.2004.02.022

Catheter cryoablation of supraventricular tachycardia : Results of the multicenter prospective "frosty" trial. / Friedman, Peter L.; Dubuc, Marc; Green, Martin S.; Jackman, Warren M.; Keane, David T J; Marinchak, Roger A.; Nazari, Jose; Packer, Douglas L; Skanes, Allan; Steinberg, Jonathan S.; Stevenson, William G.; Tchou, Patrick J.; Wilber, David J.; Worley, Seth J.

In: Heart Rhythm, Vol. 1, No. 2, 07.2004, p. 129-138.

Research output: Contribution to journalArticle

Friedman, PL, Dubuc, M, Green, MS, Jackman, WM, Keane, DTJ, Marinchak, RA, Nazari, J, Packer, DL, Skanes, A, Steinberg, JS, Stevenson, WG, Tchou, PJ, Wilber, DJ & Worley, SJ 2004, 'Catheter cryoablation of supraventricular tachycardia: Results of the multicenter prospective "frosty" trial', Heart Rhythm, vol. 1, no. 2, pp. 129-138. https://doi.org/10.1016/j.hrthm.2004.02.022
Friedman, Peter L. ; Dubuc, Marc ; Green, Martin S. ; Jackman, Warren M. ; Keane, David T J ; Marinchak, Roger A. ; Nazari, Jose ; Packer, Douglas L ; Skanes, Allan ; Steinberg, Jonathan S. ; Stevenson, William G. ; Tchou, Patrick J. ; Wilber, David J. ; Worley, Seth J. / Catheter cryoablation of supraventricular tachycardia : Results of the multicenter prospective "frosty" trial. In: Heart Rhythm. 2004 ; Vol. 1, No. 2. pp. 129-138.
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AU - Dubuc, Marc

AU - Green, Martin S.

AU - Jackman, Warren M.

AU - Keane, David T J

AU - Marinchak, Roger A.

AU - Nazari, Jose

AU - Packer, Douglas L

AU - Skanes, Allan

AU - Steinberg, Jonathan S.

AU - Stevenson, William G.

AU - Tchou, Patrick J.

AU - Wilber, David J.

AU - Worley, Seth J.

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N2 - Objective. To study the safety, efficacy, and mapping utility of a new cryoablation catheter. Background: The CryoCath Technologies Freezor catheter has been used successfully for cryoablation of supraventricular tachycardia (SVT), but has not been evaluated in a large clinical trial. Methods: A multicenter clinical trial to evaluate the safety, efficacy, and cryomapping utility of this cryoablation catheter was conducted in 166 subjects. The target of ablation was the slow pathway in patients with SVT due to AV nodal reentry (AVNRT, n = 103), an accessory pathway in patients with AV reentrant SVT (AVRT, n = 51) and the AV junction in patients with atrial fibrillation (AF, n = 12). Results: Acute procedural success (APS) was achieved in 83% of the overall group (95% CI, 76% to 88%). APS in the AVNRT group was 91% (98.3% CI, 82% to 97%), compared to 69% for AVRT (98.3% CI, 51% to 84%) and 67% for AF (98.3% CI, 29% to 93%), a highly significant difference (P < .001 by stepwise logistic regression). In patients with APS, long-term success after 6 months was 91% overall (95% CI, 86% to 96%) and 94% for AVNRT subjects (98.3% CI, 87% to 100%). None of the AVNRT or AVRT subjects required a permanent pacemaker. Cryomapping successfully identified ablation targets in 64% of patients in whom it was attempted. The electrophysiologic effects of cryomapping were completely reversible within minutes in 94% of such attempts. Conclusions: Catheter cryoablation of SVT is a safe alternative to RF ablation and is clinically effective in patients with AVNRT. Cryomapping can reversibly identify targets for ablation and can help minimize the risk of inadvertent AV block during ablation.

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KW - Atrioventricular node

KW - Catheter ablation

KW - Mapping

KW - Tachycardia

KW - Wolff-Parkinson-White syndrome

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