Abstract
Since its introduction in the mid-1980s as an experimental treatment for cardiac arrhythmias in animal models, radiofrequency (RF) catheter ablation has become the procedure of choice for a wide variety of clinical arrhythmias. While the extent of coagulation and tissue necrosis induced by RF current application depends on a variety of factors, lesions created by hyperthermia unavoidably involve a certain degree of tissue destruction that increases the risk of aneurysmal dilatation, myocardial perforation, and thromboembolic events. Over the past two decades, hypothermia has been employed in the surgical management of arrhythmias. Among the advantages of this alternative form of energy are its non-thrombogenicity and preservation of underlying tissue architecture. Recently, percutaneous cryoablation catheters have been devised and transcatheter cryoablation is emerging as a promising alternative to RF ablation.
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References
Lustgarten DL, Keane D, Ruskin J. Cryothermal ablatión: mechanism of tissue injury and current experience in the treatment of tachyarrhythmias. Prog.Cardiovasc.Dis. 1999;41:481–498.
Budman H, Shitzer A, Dayan J. Analysis of the inverse problem of freezing and thawing of a binary solution during cryosurgical processes. J.Biomed.Eng. 1995; 117:193–202.
Whittaker DK. Mechanisms of tissue destruction following cryosurgery. Ann.R.Coll.Surg.Engl. 1984;66:313–318.
Gill W, Fraser J, Carter DC. Repeated freeze-thaw cycles in cryosurgery. Nature 1968;219:410–413.
Iida S, Misaki T, Iwa T. The histological effects of cryocoagulation on the myocardium and coronary arteries. Jpn.J.Surg. 1989;19:319–325.
Mikat EM, Hackel DB, Harrison L, Gallagher JJ, Wallace AG. Reaction of myocardium and coronary arteries to cryosurgery. Lab.Invest. 1977;37:632–641.
Tsvetkov T, Tsonev L, Meranzov N, Minkov I. Functional changes in mitochondrial properties as a result of their membrane cryodestruction. II. Influence of freezing and thawing on ATP complex activity of intact liver mitochondria. Cryobiology 1985;22:111–118.
Mazur P. Cryobiology: the freezing of biological systems. Science 1970;16:939–949.
Baust J, Gage AA, Ma H, Zhang C-M. Minimally invasive cryosurgery- technological advances. Cryobiology 1997;34:373–384.
Markovitz LJ, Frame LH, Josephson ME, Hargrove WC. Cardiac cryolesions: factors affecting their size and a means of monitoring their formation. Ann.Thorac.Surg. 1988;46:531–535.
Holman WL, Ikeshita M, Douglas JMJ, Smith PK, Cox JL. Cardiac cryosurgery: effects of myocardial temperature on cryolesion size. Surgery 1983;93:268–272.
Rodriguez-Santiago A, Dubuc M, Talajic M, Roy D, Thibault B. Percutaneous catheter cryoablation in dogs: chronic lesions characterization. Can.J.Cardiol. 1999; 15: 102D.
Cooper I. Cryogenic surgery: a new method of destruction or extirpation of benign or malignant tissue. N.Engl.J.Med. 1963;268:743–749.
Ott DA, Garson AJ, Cooley DA, Smith RT, Moak J. Cryoablative techniques in the treatment of cardiac tachyarrhythmias. Ann.Thorac.Surg. 1987;43:138–143.
Berth-Jones J, Bourke J, Eglitis H, Harper C, Kirk P, Pavord S, et al. Value of a second freeze-thaw cycle in cryotherapy of common warts. Br.J.Dermatol. 1994;131:883–886.
Pease GR, Wong STS, Roos MS, Rubinsky B. MR image-guided control of cryosurgery. J.Magn.Res.Imag. 1995;5:753–760.
Hass GM, Taylor CB. A quantitative hypothermal method for the production of local injury of tissue. Arch.Pathol. 1948;45:563
Taylor CB, Davis CB, Vawter GF, Hass GM. Controlled myocardial injury produced by a hypothermal method. Circulation 1951;3:239
Harrison L, Gallagher JJ, Kasell J, Anderson RH, Mikat E, Hackel DB, et al. Cryosurgical ablation of the A-V node-His bundle: a new method for producing A-V block. Circulation 1977;55:463–470.
Lister JW, Hoffman BF. Reversible cold block of the specialized conduction tissues of the anaesthetized dog. Science 1964;145:723–725.
Gillette PC, Swindle MM, Thompson RP, Case CL. Transvenous cryoablation of the bundle ofHis. Pacing.Clin.Electrophysiol. 1991;14:504–510.
Dubuc M, Talajic M, Roy D, Thibault B, Leung TK, Friedman PL. Feasibility of cardiac cryoablation using a transvenous steerable electrode catheter. J.Interv.Card.Electrophysiol. 1998;2:285–292.
Khairy P, Rodriguez-Santiago A, Talajic M, Tardif J-C, Thibault B, Roy D, et al. Catheter cryoablation in man: early clinical experience. Can.J.Cardiol. 1999;15:173D.
Klein GJ, Sealy WC, Pritchett EL, Harrison L, Hackel DB, Davis D, et al. Cryosurgical ablation of the atrioventricular node-His bundle: long- term follow-up and properties of the junctional pacemaker. Circulation 1980;61:8–15.
Garratt C, Camm AJ. The role of cryosurgery in the management of cardiac arrhythmias. Clin.Cardiol. 1991;14:153–159.
Bredikis J. Cryosurgical ablation of atrioventricular junction without extracorporeal circulation. J.Thorac.Cardiovasc.Surg. 1985;90:61–67.
Camm J, Ward DE, Spurrell RA, Rees GM. Cryothermal mapping and cryoablation in the treatment of refractory cardiac arrhythmias. Circulation 1980;62:67–74.
Bredikis JJ, Bredikis AJ. Surgery of tachyarrhythmia: intracardiac closed heart cryoablation. Pacing.Clin.Electrophysiol. 1990; 13:1980–1984.
Louagie YA, Guiraudon GM, Klein GJ, Yee R. Closed heart cryoablation of the His bundle using an anterior septal approach. Ann.Thorac.Surg. 1991;51:616–619.
Gallagher JJ, Sealy WC, Anderson RW, Kasell J, Millar R, Campbell RWF, et al. Cryosurgical ablation of accessory AV connections. Circulation 1977;55:471–479.
Guiraudon GM, Klein GJ, Gulamhusein S, Jones DL, Yee R, Perkins DG, et al. Surgical repair of Wolff-Parkinson-White syndrome: a new closed-heart technique. Ann.Thorac.Surg. 1984;37:67–71.
Bredikis J, Bredikis A. Cryosurgical ablation of left parietal wall accessory atrioventricular connections through the coronary sinus without the use of extracorporeal circulation. J.Thorac.Cardiovasc.Surg. 1985;90:199–205.
Rowland E, Robinson K, Edmondson S, Krikler DM, Bentall HH. Cryoablation of the accessory pathway in Wolff-Parkinson-White syndrome: initial results and long term follow up. Br.Heart J. 1988;59:453–457.
Guiraudon GM, Klein GJ, Sharma AD, Milstein S, McLellan DG. Closed-heart technique for Wolff-Parkinson-White syndrome: further experience and potential limitations. Ann.Thorac.Surg. 1986;42:651–657.
Watanabe S, Koyanagi H, Endo M, Yagi Y, Shiikawa A, Kasanuki H. Cryosurgical ablation of accessory atrioventricular pathways without cardiopulmonary bypass: an epicardial approach for Wolff-Parkinson- White syndrome. Ann.Thorac.Surg. 1989;47:257–264.
Lee AW, Crawford FAJ, Gillette PC, Roble SM. Cryoablation of septal pathways in patients with supraventricular tachyarrhythmias. Ann.Thorac.Surg. 1989;47:566–568.
Gallagher JJ, Anderson RW, Kasell J, Rice JR, Pritchett ELC, Gault JH, et al. Cryoablation of drug-resistant tachycardia in a patient with a variant of scleroderma. Circulation 1978;57:190–197.
Camm AJ, Ward DE, Cory-Pearce R, Rees GM, Spurrell RAJ. The successful cryosurgical treatment of paroxysmal ventricular tachycardia. Chest 1979;75:621–624.
Krafchek J, Lawrie GM, Roberts R, Magro SA, Wyndham CR. Surgical ablation of ventricular tachycardia: improved results with a map-directed regional approach. Circulation 1986;73:1239–1247.
Page PL, Cardinal R, Shenasa M, Kaltenbrunner W, Cossette R, Nadeau R. Surgical treatment of ventricular tachycardia. Regional cryoablation guided by computerized epicardial and endocardial mapping. Circulation 1989;80:1124–1134.
Ott DA, Garson A, Cooley DA, McNamara DG. Definitive operation for refractory cardiac tachyarrhythmias in children. J.Thorac.Cardiovasc.Surg. 1985; 90:681–689.
Guiraudon GM, Thakur RK, Klein GJ, Yee R, Guiraudon CM, Sharma A. Encircling endocardial cryoablation for ventricular tachycardia after myocardial infarction: experience with 33 patients. Am.Heart J. 1994;128:982–989.
Caceres J, Werner P, Jazayeri M, Akhtar M, Tchou P. Efficacy of cryosurgery alone for refractory monomorphic sustained ventricular tachycardia due to inferior wall infarction. J.Am.Coll.Cardiol. 1988; 11:1254–1259.
Hargrove WC, Miller JM, Vassallo JA, Josephson ME. Improved results in the operative management of ventricular tachycardia related to inferior wall infarction. Importance of the annular isthmus. J.Thorac.Cardiovasc.Surg. 1986;726–732.
Miller JM, Kienzle MG, Harken AH, Josephson ME. Subendocardial resection for ventricular tachycardia: predictors of surgical success. Circulation 1984;69:624–631.
Cox JL. The status of surgery for cardiac arrhythmias. Circulation 1985;71:413–417.
Silka MJ, Kron J, Cutler JE, Wilson RA, Cobanoglu A. Cryoablation of medically refractory nodoventricular tachycardia. Pacing.Clin.Electrophysiol. 1990;13:908–915.
Kerr CR, Klein GG, Guiraudon GM, Webb JG. Surgical therapy for sinoatrial reentrant tachycardia. Pacing.Clin.Electrophysiol. 1988; 11:776–783.
Vermeulen FE, van HN, Guiraudon GM, Defauw JJ, Eibers HR, de BJ, et al. Cryosurgery for ventricular bigeminy using a transaortic closed ventricular approach. Eur.Heart J. 1988;9:979–990.
Andress JD, Vander ST, Huang SK. Bidirectional bundle branch reentry tachycardia associated with Ebstein’s anomaly: cured by extensive cryoablation of the right bundle branch. Pacing.Clin.Electrophysiol. 1991;14:1639–1647.
Assad RS, Aiello VD, Jatene MB, Costa R, Hanley FL, Jatene AD. Cryosurgical ablation of fetal atrioventricular node: new model to treat fetal malignant tachyarrhythmias. Ann.Thorac.Surg. 1995;60:S629–S632
Nitta T, Ikeshita M, Asano T, Terada K, Akiyama H, Tanaka S. Perinodal cryomodification for supraventricular tachycardia. Nippon.Kyobu.Geka.Gakkai.Zasshi. 1995;43:344–349.
Szabo TS, Jones DL, Guiraudon GM, Rattes MF, Perkins DG, Sharma AD, et al. Cryosurgical modification of the atrioventricular node: a closed heart approach in the dog. J.Am.Coll.Cardiol. 1987;10:389–398.
Klein GJ, Guiraudon GM, Perkins DG, Sharma AD, Jones DL. Controlled cryothermal injury to the AV node: feasibility for AV nodal modification. Pacing.Clin.Electrophysiol. 1985;8:630–638.
Holman WL, Ikeshita M, Lease JG, Smith PK, Lofland GK, Cox JL. Cryosurgical modification of retrograde atrioventricular conduction. Implications for the surgical treatment of atrioventricular nodal reentry tachycardia. J.Thorac.Cardiovasc.Surg. 1986;91:826–834.
Cox JL, Holman WL, Cain ME. Cryosurgical treatment of atrioventricular node reentrant tachycardia. Circulation 1987;76:1329–1336.
Hunt GB, Chard RB, Johnson DC, Ross DL. Comparison of early and late dimensions and arrhythmogenicity of cryolesions in the normothermic canine heart. J Thorac Cardiovasc Surg. 1989;97:313–318.
Peiffert B, Feldman L, Villemot JP, Verdier J. Cryosurgery in ventricular tachycardia. Value of myocardial hypothermia in the extension of the depth of cryogenic lesions. Chirurgie. 1992;118:137–143.
Klein GJ, Harrison L, Ideker RF, Smith WM, Kasell J, Wallace AG, et al. Reaction of the myocardium to cryosurgery: electrophysiology and arrhythmogenic potential. Circulation 1979;59:364–372.
Stewart GJ, Preketes A, Horton M, Ross WB, Morris DL. Hepatic cryotherapy: double-freeze cycles achieve greater hepatocellular injury in man. Cryobiology 1995;32:215–219.
Gage AA, Guest K, Montes M, Caruana JA, Whalen DAJ. Effect of varying freezing and thawing rates in experimental cryosurgery. Cryobiology 1985;22:175–182.
Fujino H, Thompson RP, Germroth PG, Harold ME, Swindle MM, Gillette PC. Histologic study of chronic catheter cryoablation of atrioventricular conduction in swine. Am.Heart J. 1993;125:1632–1637.
Dubuc M, Roy D, Thibault B, Ducharme A, Tardif JC, Villemaire C, et al. Transvenous catheter ice mapping and cryoablation of the atrioventricular node in dogs. Pacing Clin Electrophysiol. 1999;1488–1498.
Rodriguez LM, Leunissen J, Hoekstra A, Korteling BJ, Smeets JL, Timmermans C, et al. Transvenous cold mapping and cryoablation of the AV node in dogs: observations of chronic lesions and comparison to those obtained using radiofrequency ablation. J Cardiovasc Electrophysiol. 1998;9:1055–1061.
Hoekstra A de LC, Nikkeis PG, Korteling BJ, Bel KJ, Crijns HJ. Prediction of lesion size through monitoring the 0 degree C isothermic period following transcatheter cryoablation. J Interv Card Electrophysiol. 1998;2:383–389.
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© 2001 Springer Science+Business Media Dordrecht
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Khairy, P., Dubuc, M. (2001). Transcatheter Cryoablation. In: Liem, L.B., Downar, E. (eds) Progress in Catheter Ablation. Developments in Cardiovascular Medicine, vol 241. Springer, Dordrecht. https://doi.org/10.1007/978-94-015-9791-3_24
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DOI: https://doi.org/10.1007/978-94-015-9791-3_24
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