Safety and efficacy of cryoablation without the use of fluoroscopy

Cardiol J. 2018;25(3):327-332. doi: 10.5603/CJ.a2017.0065. Epub 2017 Jun 14.

Abstract

Background: Development of electroanatomical systems make it possible to perform ablations without the use of fluoroscopy. The aim of this study was to evaluate the efficacy and safety of cryoablation pro-cedures without the use of fluoroscopy.

Methods: The study group consisted of 45 patients (14 female; age 36 ± 15 years) treated with cry-oablation using the EnSite electroanatomical system: 10 with ventricular extrasystoly from the right ventricle, 6 with the arrhythmogenic site near the left coronary artery, 17 patients with Wolff-Parkinson- -White syndrome (WPW), 2 patients with atrioventricular nodal reentrant tachycardia (AVNRT) type 2, 7 patients with AVNRT type 1, 3 patients with atrial tachycardia.

Results: In 38 of the 45 patients (84%) cryoablation procedure was performed without the use of fluoroscopy. Cryoablation efficacy was 78.9%. In 5 patients unsuccessful cryoablation was fallowed by radiofrequency applications. Finally, efficacy reached 92.1%. There were no deaths. In 1 patient a small adverse event - right bundle branch block was observed after ablation of para-Hisian accessory path-way. No other adverse events were observed. In the long term follow-up efficacy was 89.5%.

Conclusions: Cryoablation using electroanatomical system without the use of fluoroscopy is a safe and efficient procedure and it is a possible alternative in most patients qualified for cryoablation.

Keywords: cardiac arrhythmias; cryoablation; electroanatomical mapping; fluoroless ablation; no-fluoroscopy.

MeSH terms

  • Adult
  • Arrhythmias, Cardiac / diagnosis
  • Arrhythmias, Cardiac / physiopathology
  • Arrhythmias, Cardiac / surgery*
  • Body Surface Potential Mapping*
  • Cryosurgery / methods*
  • Echocardiography
  • Female
  • Fluoroscopy
  • Follow-Up Studies
  • Humans
  • Imaging, Three-Dimensional*
  • Male
  • Middle Aged
  • Surgery, Computer-Assisted / methods*
  • Treatment Outcome