Chapter 9

Catheter Cryoablation for the Treatment of Ventricular Arrhythmias

Luigi Di Biase

Luigi Di Biase

Albert Einstein College of Medicine at Montefiore Hospital, New York, NY, USA

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Xue Yan

Xue Yan

University of Texas, Austin, TX, USA

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Pasquale Santangeli

Pasquale Santangeli

University of Foggia, Foggia, Italy

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Amin Al-Ahmad

Amin Al-Ahmad

Stanford University School of Medicine, Palo Alto, CA, USA

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Henry H. Hsia

Henry H. Hsia

Stanford University School of Medicine, Palo Alto, CA, USA

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David J. Burkhardt

David J. Burkhardt

Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, TX, USA

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Andrea Natale

Andrea Natale

Sutter Pacific Medical Center, San Francisco, CA, USA

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First published: 09 August 2013
Citations: 1

Summary

Radiofrequency (RF) energy is currently the most utilized energy source for the treatment of ventricular arrhythmias (VAs), especially in the settings of scar-related ventricular tachycardia (VT). This chapter examines the use of cryoenergy as an alternative source for the treatment of VAs. The goal of cryoablation is to destroy targeted cells by freezing the tissue in a discrete and focused manner. Ablation using cryoenergy relies on the Joule - Thompson effect. Cryoablation represents an alternative energy source to reduce complications during ablation of VTs originating from sites close to other relevant cardiac structures, such as the coronary sinus, phrenic nerve, atrioventricular (AV) node, and coronary artery. In rare cases, cryoenergy can also be considered epicardially when radiofrequency catheter ablation (RFCA) has failed. These considerations arose from nonrandomized studies and from data that should be considered as pilot guides for further investigations.

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