visualized continuously, thereby decreasing the
need for fluoroscopy and administration of intrave-
nous contrast.
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Acute and Long-Term Outcome of Transvenous
Cryoablation of Midseptal and Parahissian Accessory
Pathways in Patients at High Risk of Atrioventricular
Block During Radiofrequency Ablation
Felipe Atienza, MD, Angel Arenal, MD, Esteban G. Torrecilla, MD,
Arcadi Garcı ´a-Alberola, MD, Javier Jime ´nez, MD, Mercedes Ortiz, PhD,
Alberto Puchol, MD, and Jesu ´s Almendral, MD
The ability of transvenous cryothermal catheter abla-
tion to create reversible lesions (cryomapping) and to
avoid catheter dislodgment (cryoadherence) has been
shown to be safe and highly effective in elimination of
atrioventricular nodal reentrant tachycardia. In addi-
tion, cryoablation may be useful in the management
of perinodal accessory pathways, but its efficacy and
safety in patients at high risk of atrioventricular block
during radiofrequency catheter ablation is unknown.
This study prospectively evaluated the efficacy and
safety of cryoablation in patients with midseptal and
parahissian accessory pathways. 2004 by Ex-
cerpta Medica, Inc.
(Am J Cardiol 2004;93:1302–1305)
T
he ability of transvenous cryothermal catheter ab-
lation to create reversible lesions (cryomapping)
and to avoid catheter dislodgment (cryoadherence) has
shown to be safe and highly effective in eliminating
atrioventricular (AV) nodal reentrant tachycardia.
1
In
From the Electrophysiology Laboratory, Cardiology Department, Hos-
pital General Universitario Gregorio Maran ˜o ´ n, Madrid, Spain. Dr.
Arenal’s address is: Laboratorio de Electrofisiologı ´a, Hospital General
Universitario Gregorio Maran ˜o ´ n, C/Dr. Esquerdo, 46, 28007 Ma-
drid, Spain. E-mail: arenal@doymanet.es. Manuscript received
November 19, 2003; revised manuscript received and accepted
February 5, 2004.
FIGURE 5. Measurements at the level of the common ostium of the left pulmonary veins (A) and systolic peak flow velocity (B). Abbre-
viations as in Figures 1 and 4.
1302 ©2004 by Excerpta Medica, Inc. All rights reserved. 0002-9149/04/$–see front matter
The American Journal of Cardiology Vol. 93 May 15, 2004 doi:10.1016/j.amjcard.2004.02.020