Acute and long-term outcome of transvenous cryoablation of midseptal and parahissian accessory pathways in patients at high risk of atrioventricular block during radiofrequency ablation

Idiopathic ventricular arrhythmia arising from the mitral annulus

“…Use of a cryoablation catheter for IVT/PVCs from the RV septum or near the His bundle region (20) or an approach through the coronary venous system or using by percutaneous epicardial instrumentation for LV epicardial VT/PVCs (21,22) might result in the more favorable outcome. Conclusions.…”

Cryoablation time-dependent dose-response effect at minimal temperatures (-80 C): an experimental study

“…In this setting, cryomapping at −30°C creates reversible lesions that enable testing the functional effects of ablation before the formation of a permanent lesion. 1,2,10 However, the electrophysiological effects may not always be predicted by prior cryomapping at −30°C and adverse effects can be observed during cryoablation (at −70 to −80°C). 2–9 We and others have reported the occurrence of transient high-grade AVB during cryoablation at sites where previous cryomapping was judged to be ‘safe’ as verified using a navigation system.…”

“…1–9 However, the electrophysiological effects may not always be predicted by prior cryomapping at −30°C and adverse effects can subsequently be observed during cryoablation (at −70° to −80°C). 2–9 In this case, anecdotal reports suggest that, if the application is immediately interrupted, there is usually complete recovery of conduction. 2–9 We hypothesized that the reversibility of cryothermal application at the AV node is dependent, not only on the minimal temperature at the catheter tip, but also on the duration of the application.…”

“…2–9 In this case, anecdotal reports suggest that, if the application is immediately interrupted, there is usually complete recovery of conduction. 2–9 We hypothesized that the reversibility of cryothermal application at the AV node is dependent, not only on the minimal temperature at the catheter tip, but also on the duration of the application. Therefore, the objectives of this study were to: (i) establish a temporal safety window during AV nodal cryoablation at minimal temperatures (−80°C); (ii) evaluate the residual electrophysiological AV nodal impairment after reversible lesions at −80°C; and (iii) assess the histological changes related to the occurrence of AVB as a function of the duration of the cryoablation application.…”

Fluoroless cryo-ablation of para-Hisian accessory pathway

“…Although the acute procedural success rate of cryo-ablation is lower than that of radiofrequency ablation (69 % vs. 93 %), it is preferable to use cryo-ablation when the possibility of permanent AV block is more probable (5). In the case of para-Hisian accessory pathway ablation, cryo-ablation was demonstrated to be safe with no long-term complications (6,7). When the cryo-ablation procedure is successful, its long-term success rate is 91 %, which is comparable to radiofrequency ablation (5).…”