HRS: Cryoablation may be as effective as radiofrequency to treat atrial flutter

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Catheter cryoablation is comparably effective to radiofrequency catheter ablation for the treatment of atrial flutter (AFL) and may also have several safety advantages over the use of radiofrequency, according to a study published in the July edition of the Heart Rhythm.

Currently, radiofrequency catheter ablation is a very common and effective treatment of AFL, with cure rates around 95 percent. However, the study’s investigators said that radiofrequency catheter ablation can cause serious side effects, such as coagulum formation or endocardial charring, which can lead to potential long-term health complications. Catheter-based cryoablation is known to be a viable and safer alternative to radiofrequency catheter ablation; yet, its efficiency in treating AFL had not previously been systematically evaluated in a large clinical trial.

The study is the first multi-center study to prove the acute and long-term safety and efficacy of catheter based-cryoablation for the treatment of AFL, reporting six-month follow-up results, according to the authors.  

Gregory K. Feld, MD, from division of cardiology at the University of California San Diego School of Medicine, and colleagues performed catheter-based cryoablation at 12 medical centers in a total of 160 patients with cavotricuspid isthmus-dependent AFL. Patients were evaluated at one, three and six months and underwent weekly and symptomatic event monitoring.

The study revealed 90.2 percent of patients remained clinically free of AFL, proving the effectiveness of cryoablation in the treatment of AFL, according to the researchers.

“A study of this size, performed at multiple centers, better validates the safety and efficacy of a device for arrhythmia treatment, compared to smaller, single center studies,” Feld said. “The validity of this large multi-center study proves that cryoablation is reliable treatment of atrial flutter, and is further supported by the many safety advantages cryoablation offers over radiofrequency treatment.”

Based on their results, the researchers said that cryoablation also presents a number of safety advantages over radiofrequency, including: less pain, less risk of coagulum formation, less risk of causing heart block and no risk of causing pulmonary vein stenosis, which is the narrowing of the vein caused by heating.