Transvenous cryothermal catheter ablation of re-entry circuit located near the atrioventricular junction in pediatric patients

Drago, Fabrizio; Santis, Antonella De; Grutter, Giorgia; Silvetti, Massimo Stefano

doi:10.1016/j.jacc.2004.12.048

Cited by 79 publications

(53 citation statements)

References 25 publications

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“…This could be explained by the fact that cryolesions are well circumscribed and homogeneous, and show fibrotic tissue without signs of chronic inflammation and no evidence of viable myocytes. On the basis of the above-mentioned properties of cryolesions as well as of catheter stability during energy delivery, cryoablation shows specific advantages over RF when ablation is performed in children [28].…”

Section: Discussionmentioning

confidence: 99%

Acute and long-term outcome of transvenous cryothermal catheter ablation of supraventricular arrhythmias involving the perinodal region

Gaïta¹,

Montefusco²,

Riccardi³

et al. 2006

Journal of Cardiovascular Medicine

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Section: Discussionmentioning

confidence: 99%

Acute and long-term outcome of transvenous cryothermal catheter ablation of supraventricular arrhythmias involving the perinodal region

Gaïta¹,

Montefusco²,

Riccardi³

et al. 2006

Journal of Cardiovascular Medicine

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“…Superiorities of cryoablation are as follows: (1) safety, (2) low risk of heart block, (3) better catheter stabilization, and (4) less thrombogenicity. Cryoablation is a newer method of ablation, which has proven to be safe in many studies . An acute success rate of cryoablation is 95% for AVNRT .…”

Section: Discussionmentioning

confidence: 99%

Successful Cryoablation of Atrioventricular Nodal Reentrant Tachycardia and Coexisting Accessory Pathways without Fluoroscopy

Gül

Ugur

Akdeni̇z

et al. 2012

Congenital Heart Disease

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We report the case of a 14-year-old boy patient admitted to our outpatient clinic with palpitations and documented supraventricular tachycardia. Electrophysiological study and ablation were planned. In the electrophysiological study, two tachycardias with different cycle lengths and morphologies were induced. After elimination of the slow pathway, left posterior accessory pathway was detected and successfully ablated. Another pathway was detected following that ablation. Due to the slow retrograde conduction of this pathway, diltiazem infusion was started to uncover the accessory pathway. The second accessory pathway was at the left posteroseptal region and was successfully ablated. After a 30-minute waiting period, no tachycardia was induced. In addition, no fluoroscopy was used during the procedure.

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“…39 In addition, cryoablation therapy may not be as durable as radiofrequency, as was seen in some studies of supraventricular tachycardia ablation. 40,41 At this point, balloonbased ablation systems have not been proven to be as effective as current techniques and do not appear to save procedure time.…”

Section: Balloon-based Ablation Systemsmentioning

confidence: 99%

New Technologies in Atrial Fibrillation Ablation

Burkhardt

Natale

2009

Circulation

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he treatment of atrial fibrillation has changed greatly in the past decade. Not long ago, the scientific community argued the benefits of a rate-control strategy versus a rhythmcontrol strategy. 1 This argument was always hampered by the relative ineffectiveness of the antiarrhythmic medications used as rhythm-control agents. Ablation therapy for the treatment of atrial fibrillation has quickly evolved. Originally, ablation was focused on finding triggers of atrial fibrillation in the pulmonary veins. 2,3 Now, ablation offers a potential curative strategy for patients with paroxysmal, persistent, or permanent atrial fibrillation. Recent data continue to show that atrial fibrillation ablation is superior to the currently available antiarrhythmic medications in the maintenance of sinus rhythm, and the Food and Drug Administration has approved devices labeled for the ablation of atrial fibrillation. 4 -6 It is estimated that Ͼ2 million people in the United States have atrial fibrillation. 7 Although the number of atrial fibrillation ablations continues to increase year after year, offering this therapy to all potential candidates is impossible because of several limitations. 8,9 A finite number of fellows are being trained in programs that offer a great deal of experience in atrial fibrillation ablation, and there is limited opportunity for practicing electrophysiologists to learn new techniques. Unlike supraventricular tachycardia ablation, atrial fibrillation ablation requires greater technical skill, significantly more lesions, and time. Like many other medical procedures, technological innovation is likely to be a contributing factor in making atrial fibrillation ablation a more commonplace and widely practiced therapy.Navigating the complex anatomy of the left atrium is also difficult to master. Imaging technologies have been used to orient the operator to the anatomy and the location of the ablation catheters in this anatomy. With fluoroscopy alone, it is difficult to determine anterior versus posterior orientation or the presence of the catheter in a pulmonary vein versus the left atrial appendage. Intracardiac echocardiography (ICE) provides 2-dimensional navigation assistance and excellent anatomic detail; however, it is difficult to locate the catheter tip at all times in the echocardiography field. Without 3-dimensional (3D) imaging, navigation with ICE alone is also difficult. Electroanatomic mapping (EAM) systems offer a 3D view and nearly real-time catheter tip localization within a created construct of the left atrium, but the data are heavily dependent on the input of the operator and cartographer. Newer technology has merged these 2 imaging modalities to offer the best of both worlds.Remotely obtained computed tomography (CT) imaging of the left atrium has been performed to define the complex anatomy of the left atrium. This can be integrated into EAMs or imaging systems to aid in navigation and procedure planning. However, conditions at the time of CT may be different from those at the time of a...

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Transvenous cryothermal catheter ablation of re-entry circuit located near the atrioventricular junction in pediatric patients

Abstract: Acute results demonstrate cryoablation of SVTs with the reentry circuit located near the atrioventricular junction to be safe and efficacious in pediatric patients. However, the etiology of recurrences reported after intervention need further investigation.

Cited by 79 publications

References 25 publications

Acute and long-term outcome of transvenous cryothermal catheter ablation of supraventricular arrhythmias involving the perinodal region

Acute and long-term outcome of transvenous cryothermal catheter ablation of supraventricular arrhythmias involving the perinodal region

Successful Cryoablation of Atrioventricular Nodal Reentrant Tachycardia and Coexisting Accessory Pathways without Fluoroscopy

New Technologies in Atrial Fibrillation Ablation

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