CryoCure-VT: Endocardial ultra-low temperature cryoablation effective in sustained monomorphic ventricular tachycardia

Endocardial ultra-low temperature cryoablation showed efficacy in reducing clinical ventricular tachycardia with rare serious adverse events, according to the early-phase CryoCure-VT study.

CryoCure-VT (NCT04893317) was a first-in-human trial including participants eligible for catheter ablation due to ischaemic and/or non-ischaemic recurrent symptomatic sustained monomorphic ventricular tachycardia, who were refractory to at least 1 anti-arrhythmic drug [1]. The ultra-low temperature cryoablation catheter could be used to titrate the lesion depth based on the length of the freezing procedure.

The primary procedural endpoint was device-related or procedure-related major adverse events, defined as the proportion of participants with non-inducible clinical ventricular tachycardia at the end of the procedure. The clinical efficacy primary endpoint was freedom from recurrent sustained monomorphic ventricular tachycardia or therapy at 6 and 12 months post-procedure. A total of 64 participants were included. The mean procedure time was 188 min, including a mean ablation time of 42 min and a mean freeze time of 34 min. Lesions were delivered in all locations, including the lateral, anterior, septal, and inferior locations.

Serious adverse events were rare and included 1 case of an asymptomatic false aneurysm, 2 cases of small/trivial pericardial effusion, and 1 case of haemodynamic instability during the procedure. In terms of procedural efficacy, 94.4% of the participants had no inducible clinical ventricular tachycardia, while 85.2% of the participants had no inducible ventricular tachycardia of any kind, with a total proportion of 97.1% (100/103) of clinical ventricular tachycardias eliminated. At 8 months, 81.0% of the participants were free from implantable cardioverter defibrillator therapy, and 60.3% of the participants were free from any ventricular tachycardia longer than 30 sec. Finally, there was a 60% drop in amiodarone use and dosage following the ultra-low temperature cryoablation procedure.

“Endocardial ultra-low temperature cryoablation appears to be safe and effective in this first-in-human study,” concluded Dr Atul Verma (McGill University Health Centre, Quebec, Canada). However, “further post-marketing research is required, and additional studies are ongoing.”

1. 
   
   1. Verma A, et al. The safety and effectiveness of ultra-low temperature cryoablation of monomorphic VT in patients with ischemic and non-ischemic cardiomyopathies. Late-Breaking Science: ablation. EHRA Congress 2024, 7–9 April, Berlin, Germany.

Copyright ©2024 Medicom Medical Publishers



Posted on 29 April 20241 May 2024