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The CRYOCURE VT TRIAL study: a new energy available for ventricular tachycardia ablations?
Key messages
- Efficacy and safety in humans of a new ultra-low temperature ablation energy
Introduction
Radiofrequency ablation of ventricular tachycardia (VT) encounters limitations in lesion depths. CRYOCURE VT TRIAL is a multicenter study that investigated VT ablation by Ultra Low Temperature (- 196 degrees). This technique allows lesions with a titratable depth of up to 13.5 mm depending on the duration of the application. The catheter is 10 French and has 8 1 mm electrodes.
Methodology and results
Method: 64 patients, 67 years old, 95% of whom were men, presenting VT refractory to medical treatment were included. 81% ischemic heart disease.
50% of ablations were carried out under general anesthesia which is therefore not essential. All endocardial myocardial areas could be reached.
Results
Procedure duration: 188 min including 34 min of cryotherapy. 9 Shots of 3.8 min per patient on average, deliberately reduced for this first human trial. Fluoroscopy 19 min.
Safety: 0% major side effects as defined by the protocol, but 1 false aneurysm, 2 pericardial effusions, and 1 hemodynamic instability.
Acute success: non-inducible clinical VT in 94% of cases. TV of any type not inducible in 85% of cases.
Remote success: 81% of patients had no shock from their ICD at 6 months. 60% did not have VT > 30 sec at 6 months. Results were similar for ischemic and nonischemic heart disease.
Figure 2
Conclusion
The authors conclude that this technique is satisfactory in its effectiveness and safety for the ablation of ventricular tachycardias.
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References
Atul Verma, Vidal Essebag, Petr Neuzil, Katia Dyrda, Jippe Balt, Borislav Dinov, Angeliki Darma, Arash Arya, Frederic Sacher, Vivek Y Reddy, Lucas Boersma, Ilya Grigorov, Tom De Potter, Cryocure-VT: the safety and effectiveness of ultra-low-temperature cryoablation of monomorphic ventricular tachycardia in patients with ischaemic and non-ischaemic cardiomyopathies, EP EuropaceVolume 26, Issue 4, April 2024, euae076, https://doi.org/10.1093/europace/euae076
