Approaching a decade of cryo catheter ablation for type 1 atrial flutter-a meta-analysis and systematic review

Peter Andrew, Yasir Hamad, Sandra Jerat, Annibale Montenero, Stephen O'Connor

Research output: Contribution to journalArticlepeer-review


Purpose: Despite increasingly widespread use of cryo catheter ablation (CCA) in clinical practice, current ACC/AHA/ESC guidelines for management of supraventricular arrhythmias cite only radiofrequency catheter ablation (RFCA) as first-line treatment for type 1 atrial flutter (AFL). We performed a meta-analysis of efficacy and procedure outcomes from randomized controlled clinical trials comparing CCA with RFCA for type 1 AFL. A systematic review of non-randomized, single-arm clinical studies of CCA for type 1 AFL was also done. Methods: An English language search of Medline, Cochrane, Embase, and an extensive bibliography search from January 2000 to May 2010 was conducted. Inclusion/exclusion criteria were met by six randomized clinical trials for meta-analysis (n∈=∈341) and 13 non-randomized, single-arm clinical studies for systematic review (n∈=∈763). Four primary outcomes were analyzed, namely, percent of patients with bidirectional conduction block (BCB) at procedure, proportion of patients who were asymptomatic during follow-up, procedure time, and fluoroscopy time. Results: Random effect analyses for CCA versus RFCA favored the latter ablation modality for percent of patients with BCB at procedure (84.3% vs. 93.3%; OR∈=∈0.51; p∈=∈0.14). A similar proportion of patients were asymptomatic during follow-up (85.5% vs. 87.3%; OR∈=∈0.68; p∈=∈0.53). A significantly longer procedure time was determined for CCA (171.7 min vs. 134.5 min; Std diff means∈=∈0.57; p∈

Original languageEnglish
Pages (from-to)17-27
Number of pages11
JournalJournal of Interventional Cardiac Electrophysiology
Issue number1
Publication statusPublished - Oct 2011


  • Arrhythmia
  • Atrial flutter
  • Catheter
  • Cavotricuspid isthmus
  • Cryo
  • Radiofrequency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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