AIMS: The purpose of this study was to evaluate the safety and efficacy of cryoablation in a large series of patients with typical (slow-fast) atrioventricular nodal reentrant tachycardia (AVNRT). METHODS AND RESULTS: Between 2003 and 2007, 312 patients with typical AVNRT--median age of 53 years (range 10-92), 200 women (64%)--underwent cryoablation, using exclusively a 6 mm tip catheter tip. Acute success was achieved in 309 of 312 patients (99%). The overall recurrence rate was 18 of 309 (5.8%) during a mean follow-up of 673 +/- 381 days. Sixteen of these patients (89%) were successfully reablated. The recurrence rate was 9% in patients with residual dual atrioventricular (AV) nodal pathway post-ablation compared with 4% in those with complete elimination of slow pathway conduction (P = 0.05). No patient developed permanent AV block. CONCLUSION: Cryoablation of AVNRT can be achieved with a high acute success rate and a reasonable recurrence rate at long-term follow-up. Complete abolition of slow pathway conduction seems to predict better late outcome.