Chapter 8
Catheter Cryoablation for the Treatment of Accessory Pathways
Book Editor(s):Ngai-Yin Chan MBBS, FRCP, FACC, FHRS,
Ngai-Yin Chan MBBS, FRCP, FACC, FHRS
Head, Cardiac Pacing Service and Head, Cardiac Rehabilitation Service, Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
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This chapter reviews the data on radiofrequency (RF) catheter ablation of accessory pathways (APs) with special emphasis on its limitations. It discusses in detail the use of an alternative source of energy, cryothermy, in the treatment of APs, including its potential advantages, practical application, current data, and limitations. Some uncommon complications of radiofrequency catheter ablation (RFCA) for APs are described. These include coronary artery spasm and injury, autonomic nerve injury, and inadvertent AVB during ablation of nonseptal APs. The data on the performance of catheter cryoablation in treating APs are scarce. Studies with small numbers of patients have been performed in both adult and pediatric populations. The primary advantage of catheter cryoablation is the ability to create a more focused lesion and the availability of the cryomapping function. The unique properties of cryomapping and cryoadhesion further improve the safety profile of this energy source.
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