The Practice of Catheter Cryoablation for Cardiac Arrhythmias

Cover......Page 1
Title page......Page 5
Copyright page......Page 6
Contents......Page 7
List of Contributors......Page 8
Preface......Page 10
Acknowledgments......Page 11
About the Companion Website......Page 12
Joule–Thompson effect......Page 13
Modern cryoablation system......Page 14
Hypothermic stress......Page 15
Immediate postthaw phase......Page 16
Cooling rate......Page 17
Conclusion......Page 18
References......Page 19
Cryoablation in immature myocardium – animal studies......Page 20
Cryoablation technique – general aspects......Page 21
Outcomes of cryoablation for pediatric AVNRT......Page 22
Outcomes of cryoablation of accessory pathway ablation in pediatrics......Page 25
Cryoablation for other substrates......Page 26
Practice trends in pediatric cryoablation......Page 27
References......Page 28
Basis of catheter ablation for AVNRT......Page 30
Combined anatomical and electrophysiological approach......Page 32
Variation of retrograde exit sites and presence of multiple AV nodal pathways......Page 35
Congenital heart disease......Page 37
Potential proarrhythmic effects of catheter ablation......Page 38
Short- and long-term follow-up evaluation......Page 40
Elderly population......Page 41
Lessons learned from RFCA......Page 42
References......Page 43
Atrioventricular block after radiofrequency catheter ablation for atrioventricular nodal reentrant tachycardia......Page 48
Is cryoablation free of the complication of permanent inadvertent AVB in the treatment of AVNRT?......Page 49
Other advantages of using cryoablation to treat AVNRT......Page 50
Recurrence rates: The Achilles’ Heel of cryoablation in treating AVNRT......Page 51
Cryomapping......Page 52
A more robust ablation endpoint......Page 54
Use of an 8 mm tip cryocatheter......Page 55
References......Page 56
Introduction......Page 59
Function of the Arctic Front cryoballoon......Page 60
Factors determining lesion size and homogeneity......Page 61
Confirming adequate balloon occlusion......Page 62
Impact of pulmonary vein anatomy......Page 63
Imaging......Page 64
Left upper pulmonary vein......Page 65
Right upper pulmonary vein......Page 66
Confirming isolation......Page 67
Monitoring pulmonary vein signals......Page 68
Risk of phrenic nerve palsy......Page 70
Stroke and transient ischemic attack......Page 72
Left atrial esophageal fistula......Page 73
Cough and hemoptysis......Page 74
Anticoagulation......Page 75
References......Page 76
Anatomy......Page 79
Mechanisms of phrenic nerve injury......Page 80
Pacing the phrenic nerve......Page 81
Fluoroscopy and palpation......Page 83
Intracardiac echocardiography and fetal heart monitoring......Page 84
Diaphragmatic compound motor action  potential......Page 85
Using capnography as an adjunctive tool for monitoring phrenic nerve function......Page 88
Recommendations......Page 89
See it, hear it, feel it, and measure it......Page 90
What to do when phrenic nerve injury occurs......Page 91
References......Page 92
Pathophysiologic mechanisms of AFL......Page 94
Mapping of AFL......Page 95
Radiofrequency catheter ablation of AFL......Page 97
Outcomes of radiofrequency catheter ablation of typical AFL......Page 99
Cryocatheter ablation of typical AFL......Page 104
References......Page 108
Performance of RFCA of APs......Page 111
Potential advantages of using cryoablation instead of RFCA in the treatment of APs......Page 113
Efficacy, safety, and recurrence in general......Page 114
Cryomapping failure......Page 118
Conclusions......Page 120
References......Page 122
History of cryoablation......Page 125
Lesion formation by cryothermal energy......Page 126
Cryoablation in the settings of VT ablation: clinical studies......Page 127
References......Page 130
Electrophysiological characteristics and anatomical locations of focal atrial tachycardia......Page 132
Catheter cryoablation treatment for “high-risk” FAT......Page 133
Radiofrequency and cryothermal ablation for inappropriate sinus tachycardia......Page 134
References......Page 139
Index......Page 143