Atrioventricular Node Arrhythmia
Conditions
Keywords
AVNRT, Cryoablation, PR interval
Brief summary
In this study a new technique for ablation in atrioventricular nodal reentrant tachycardia using cryo-energy will be studied in cases where the standard approach has higher risk.
Detailed description
Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common cause of fast heartbeats in young people. People with AVNRT have two pathways within the heart, the fast pathway (FP) and slow pathway (SP). A treatment for AVNRT is ablation (burning or freezing) of the SP. This can be done with either radiofrequency or cryo-energy. A complication which occurs in 1% of cases is AV block (AVB), meaning the person needs a pacemaker. Slow pathway ablation is a problem in people when the electrocardiogram (ECG) shows a long PR interval, with greater rates of AVB. This accounts for 5% of AVNRT cases. A possible solution is to treat the FP with cryo-energy and leave the SP intact. This pilot study aims to show this is safe and effective.
Interventions
PROCEDURECardiac catheter ablation
Cryoablation
Sponsors
University of Western Ontario, Canada
London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Prospective model with two groups based on PR interval on ECG, normal and prolonged PR
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Documented supraventricular tachycardia (SVT) * Planned to undergo electrophysiology (EP) study and ablation * PR interval on ECG \<220ms (Group 1) or \>220ms (Group 2)
Exclusion criteria
* Pregnancy * Age \<18 years * Inability to provide consent * High likelihood of tachycardia mechanism other than AVNRT (e.g. Pre-excitation on surface ECG, atrial tachycardia)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Termination of AVNRT | One day | Number of participants where cryotherapy terminates AVNRT |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Freedom from recurrence | 1 year | Number of participants with no recurrence of AVNRT during follow-up |
| Incidence of AV block | 1 year | Number of participants where AV block is observed |
| Cardiac tamponade | 1 year | Number of participants with pericardial effusion and/or tamponade following procedure |
| Vascular complications | 1 year | Number of participants with groin hematoma or fistula requiring intervention following procedure |
Other
| Measure | Time frame |
|---|---|
| Procedural time | Immediate |
| Fluoroscopy time | Immediate |
Countries
Canada
Contacts
Primary ContactMatthew K Rowe, MBBS
Backup ContactAllan Skanes, MD
Outcome results
None listed