Cryothermal Energy Ablation Of Cardiac Arrhythmias 2005: State Of The Art



Roberto De Ponti, “Cryothermal Energy Ablation Of Cardiac Arrhythmias 2005:
State Of The Art”

20


veins stenosis and thromboembolic events is expected to be dramatically reduced by using
cryoablation. On the other hand, the presence of high blood flow in the pulmonary vein may
represent a considerable heat load, which may limit the size and depth of the lesion produced by
cryothermal energy at the os of the pulmonary vein. Moreover, the longer time required to
produce a permanent lesion may relevantly reflect on procedure duration, limiting the clinical
use of this theoretically optimal energy source. Initial experiences of electrophysiologically-
guided segmental ostial ablation of the pulmonary vein by using cryothermal energy application
with 10 or 7 F catheters
20,41 have been reported. These experiences show that pulmonary vein
isolation is feasible with a comparable number of applications and clinical outcome with regard
to radiofrequency ablation; longer procedural times, observed for both the 10 F and the 7 F
catheter, correlate with longer application times required when cryothermal energy is used.


Figure 3. Example of disappearance of ventricular preexcitation in a case of
parahissian accessory pathway. Surface ECG and bipolar recordings from the distal
(ABLd) and proximal (ABLp) electrode pairs of the cryoablation catheter are
displayed. The relative position of His bundle and the accessory pathway has been
identified during accurate mapping, also during orthodromic atrioventricular
reentrant tachycardia. Accessory pathway turned out to be located at the same site
where a high amplitude His bundle potential was recorded. In this figure, the tip
electrode temperature is -23°C and minor artefacts in ABLd suggest that ice is
forming on the tip electrode. In the first sinus beat, ventricular preexcitation is still
present with optimal A-V and V-delta interval recorded at this site. In the second
beat, conduction over the accessory pathway is interrupted with disappearance of
ventricular preexcitation; now a high amplitude His bundle potential is well evident
in the distal electrode pair of the ablation catheter. Permanent ablation of this
parahissian pathway could be accomplished by limited cryothermal energy delivery
in this site with no modification of conduction over the normal atrioventricular
conduction pathway.

Indian Pacing and Electrophysiology Journal (ISSN 0972-6292), 5(1): 12-24 (2005)



More intriguing information

1. The name is absent
2. LOCAL CONTROL AND IMPROVEMENT OF COMMUNITY SERVICE
3. Testing Panel Data Regression Models with Spatial Error Correlation
4. The name is absent
5. What Lessons for Economic Development Can We Draw from the Champagne Fairs?
6. Developing vocational practice in the jewelry sector through the incubation of a new ‘project-object’
7. The name is absent
8. Biological Control of Giant Reed (Arundo donax): Economic Aspects
9. Developmental Robots - A New Paradigm
10. Meat Slaughter and Processing Plants’ Traceability Levels Evidence From Iowa
11. A Classical Probabilistic Computer Model of Consciousness
12. DETERMINANTS OF FOOD AWAY FROM HOME AMONG AFRICAN-AMERICANS
13. Credit Market Competition and Capital Regulation
14. A Note on Costly Sequential Search and Oligopoly Pricing (new title: Truly Costly Sequential Search and Oligopolistic Pricing,)
15. The urban sprawl dynamics: does a neural network understand the spatial logic better than a cellular automata?
16. The name is absent
17. Changing spatial planning systems and the role of the regional government level; Comparing the Netherlands, Flanders and England
18. The name is absent
19. Accurate and robust image superresolution by neural processing of local image representations
20. The name is absent