Circulation, Vol 55, 471-479, Copyright © 1977 by American Heart Association
JJ Gallagher, WC Sealy, RW Anderson, J Kasell, R Millar, RW Campbell, L Harrison, EL Pritchett and AG Wallace
Cryothermia, a new technique for definitive treatment of the pre-
excitation syndrome, is described in two patients. The first patient
presented with a normal P-R interval with a delta wave and reciprocating
tachycardia. Preoperative electrophysiologic study suggested a free-wall
atrioventricular connection on the left posterior atrioventricular (A-V)
groove. At surgery, epicardial mapping confirmed the site of pre-excitation
on the posterior left ventricular (LV) wall. An electrogram arising from
the accessory pathway (AP) was recorded at the site of earliest ventricular
activation. Interatrial delay combined with an apparently long accessory
pathway to the ventricle caused the P- R interval to appear normal. Local
pressure abolished pre-excitation. The site of early ventricular activation
was cooled to -60 degrees C with a specially designed cryoprobe. All
evidence of pre-excitation and arrhythmias disappeared. The second patient
presented with a refractory reciprocating tachycardia and was found to have
an AP in the septum capable of only retrograde conduction. Retrograde
conduction was abolished by applying a temperature of 0 degrees C to the
anulus at this site during tachycardia. Conduction over the AP and
reciprocating tachycardia returned with rewarming. Ablation of the AP was
obtained by applying a temperature of -60 degrees C for 90 seconds on two
occasions to the same area. The His bundle was not injured.
ARTICLES
Cryosurgical ablation of accessory atrioventricular connections: a method for correction of the pre-excitation syndrome
This article has been cited by other articles:
 |
|
 |
|
  S. Masroor, M.-E. Jahnke, A. Carlisle, C. Cartier, J.-P. LaLonde, T. MacNeil, A. Tremblay, and F. Clubb Jr. Endocardial hypothermia and pulmonary vein isolation with epicardial cryoablation in a porcine beating-heart model. J. Thorac. Cardiovasc. Surg., June 1, 2008; 135(6): 1327 - 1333.e5. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A.M.J. Theuns, G. P. Kimman, T. Szili-Torok, J. C.J. Res, and L. J. Jordaens Ice mapping during cryothermal ablation of accessory pathways in WPW: the role of the temperature time constant Europace, January 1, 2004; 6(2): 116 - 122. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Cox Intraoperative options for treating atrial fibrillation associated with mitral valve disease J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(90030): S24 - 27. [Full Text] [PDF]
|
|
|
|
|
|
J. L. Cox Intraoperative options for treating atrial fibrillation associated with mitral valve disease J. Thorac. Cardiovasc. Surg., August 1, 2001; 122(2): 212 - 215. [Full Text] [PDF]
|
|
|
|
 |
|
 F. Gaita, R. Gallotti, L. Calo, E. Manasse, R. Riccardi, L. Garberoglio, F. Nicolini, M. Scaglione, P. Di Donna, D. Caponi, et al. Limited posterior left atrial cryoablation in patients with chronic atrial fibrillation undergoing valvular heart surgery J. Am. Coll. Cardiol., July 1, 2000; 36(1): 159 - 166. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Watanabe, J.-i. Hayashi, M. Sugawara, M. Hiratsuka, and S. Eguchi Experimental application of microwave tissue coagulation to ventricular myocardium Ann. Thorac. Surg., March 1, 1999; 67(3): 666 - 671. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. Manolis and N. A. M. Estes III Supraventricular Tachycardia: Mechanisms and Therapy Arch Intern Med, October 1, 1987; 147(10): 1706 - 1716. [Abstract] [PDF]
|
|
|
|
 |
|
 Questions and Answers JAMA, July 17, 1987; 258(3): 384 - 386. [PDF]
|
|
|
|
 |
|
 D. W. Benson JR and J. J. Gallagher Electrophysiologic Evaluation and Surgical Correction of Wolff-Parkinson-White Syndrome in Children Clinical Pediatrics, September 1, 1980; 19(9): 575 - 583. [Abstract] [PDF]
|
|