Cryosurgical ablation of accessory atrioventricular pathways without cardiopulmonary bypass: An epicardial approach for Wolff-Parkinson-White syndrome

Transcatheter Cryoablation Part I: Preclinical Experience

“…One pathway was concealed and paraseptal and the second manifest and left-sided. Several case series followed, [33][34][35][36][37][38] with the largest reporting an epicardial approach in 105 consecutive patients with Wolff-Parkinson-White syndrome (74 left lateral, 23 paraseptal, and 11 right ventricular free wall). 36 The AV fat pat was mobilized and dissected and the accessory pathway exposed and cryoablated.…”

Surgical procedure for right anteroseptal accessory conduction pathways in Wolff-Parkinson-White syndrome

“…In the surgical procedure, either an endocardial or epicar-dial approach is taken. The epicardial approach does not require cardioputmonary bypass and the success rate is generally high [9]. However, an epicardial approach for right anteroseptal ACP is difficult.…”

Experimental study of cryofreezing energy applications on the ventricular myocardium using sheep hearts

“…However, the result of catheter ablation using radiofrequency energy has not been satisfactory especially when applied to ventricular tachyarrhythmias, presumably because of the small size of the lesions created or insufficient penetration through the myocardium . Catheter cryoablation is one of the promising and anticipated therapeutic methods, which is estimated to make sufficiently wide and deep lesions necessary for a successful ablative intervention for intramural or epicardial ventricular tachyarrhythmias or atrioventricular accessory pathways at difficult locations like anteroseptal pathways . This study was performed to assess the feasibility of catheter‐based cryoablation using the endocardial applications with hand‐held surgical cryoprobe by measuring the epicardial pacing threshold, ventricular electrograms, and lesion volume.…”