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Performance of a New Cardiac Cryoablation System in the Treatment of Cavotricuspid Valve Isthmus-Dependent Atrial Flutter
Authors:JAMES P. DAUBERT,ROBERT H. HOYT&dagger  ,ROY JOHN&Dagger  ,LARRY CHINITZ§  ,DAVID T. MARTIN&Dagger  ,CHRISTOPHER FELLOWS&#  ,GREGORY FELD¶  ,WILLIAM PELKEY#, RUCHIR SEHRA,for theCryoCor Atrial Flutter Investigators
Affiliation:From the Cardiology Unit, Department of Medicine, University of Rochester Medical Center, Rochester, New York;, Iowa Heart Center, Iowa;, Lahey Clinic, Burlington, Massachusetts;, New York University Medical Center, New York City, New York;, Virginia Mason Medical Center, Virginia;, University of California San Diego, San Diego, California;, and Cryocor, Inc., San Diego, California
Abstract:
We sought to evaluate prospectively the safety and efficacy of cryothermal energy to ablate typical atrial flutter (AFL). Ablation of cardiac tissue using cryothermal energy has recently been developed as an alternative to radiofrequency energy, which may offer certain advantages in the treatment of AFL. This prospective, multicenter nonrandomized study of a new catheter-based system for the treatment of cavotricuspid isthmus (CTI)-dependent AFL enrolled patients between 18 and 75 years of age. The CTI dependence of AFL was confirmed at electrophysiologic study with activation mapping and/or entrainment. Patients with atrial septal defect, recent myocardial infarction, left ventricular ejection fraction <0.30, or prior AFL ablation were excluded. Cryoablation of AFL was performed in 48 patients from 11 centers. The procedure was immediately successful in 45 patients (94%), and effective in 30 of 40 patients with complete data available at 6 months. Cryoablation is a promising new treatment of CTI-dependent AFL refractory to medical therapy. Further improvements in catheter design and intravascular sheaths will be tested in a larger multicenter trial.
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