Introduction: While in radiofrequency ablation for AVNRT a residual jump and a single echo do not seem to substantially modify long term results, in cryoablation procedures their effects are not well defined and are still under evaluation.Methods: Inclusion criteria: acute successful slow pathway cryoablation for AVNRT. Exclusion criteria: use of a 4 mm tip catheter, no baseline elicitable jump, no baseline inducible AVNRT, and unwanted persistent 1st degree AV block at the end of the procedure. Cryoablation (-80°C for 4 min) was applied after successful cryomapping if no AV block occurred. AVNRT inducibility was checked 30 min later with or without isoproterenol. Acute procedural success was defined as AVNRT noninducibility. No drugs were given at hospital discharge.Results: Among 262 patients (pts) who had undergone cryoablation in our institution from may 2004 to march 2010, 218 of them fulfilled the entry criteria. There were 115 women, mean age was 40±15 years, and number of ineffective drugs 1.9±1.3. A 7 Fr 6-mm-tip cryocatheter (CryoCath®) was used in all. Baseline AV nodal effective refractory period (ERP) was 272±49 ms, post-procedural ERP 327±54 ms (p<0.001), and the difference between baseline and post-procedural ERP 61±41 ms. A/V ratio at successful site was 1±0.4. Forty-eight pts (22%) had a residual jump at the end of the procedure, 18 of them have an associated single echo. Global cryoapplication time was 995±756 sec. During a mean follow-up of 2.5±1.5 years, 40 pts (18%) had AVNRT recurrences. Using Coxʼs model, univariate predictors of recurrence were residual jump (p<0.02), and global cryoapplication time (p<0.001). At multivariate analysis, only global cryoapplication time was independently significant (p<0.001), suggesting that a prolonged cryoapplication time is correlated with more difficult procedures in the case of residual jump. At 12-months follow-up, actuarial rate of recurrence-free pts was 85% in the group without residual jump (170 pts), 70% with residual jump and no echo (30 pts), and 67% with residual jump associated with a single echo (p<0.02 among groups).Conclusions: In patients undergoing AVNRT cryoablation, slow-pathway conduction suppression is correlated with a better outcome. A time consuming procedure should be performed in cases with difficult slow pathway abolition. A single echo is associated with a recurrence risk similar to residual jump without echo.