Catheter Cryoablation

Abstract

By the early 1960s, a synthesis of experiments predominantly focused on frostbite and cryopreservation demonstrated that the major mechanisms of cold-induced cellular and tissue injury result from a combination of (1) direct cellular damage attributable to the deleterious effects of ice crystal formation (Circ Arrhythm Electrophysiol. 2013;6:218-227.)

Cooling dynamics: a new predictor of long-term efficacy of atrioventricular nodal reentrant tachycardia cryoablation

“…This difference is due to the mechanisms of lesion formation of the two energy sources. Compared to RFCA, cryoablation produces a smaller and more circumscribed lesion, mainly due to the adherence of the catheter to the endocardium during the application [25]. Overall, several factors have been investigated.…”

Incidence and Significance of Early Recurrences of Atrial Fibrillation After Cryoballoon Ablation

“…11,12 Acute thermal injury effectuated by RF is characterized by coagulation and tissue necrosis and is followed by a marked inflammatory response within the atria, resulting in cellular dysfunction and enhanced arrhythmogenicity. These changes are thought to be mechanistically central to the occurrence of ERAF.…”

“…In contrast, cryoablation results in the creation of dense, well-demarcated homogeneous lesions through a directed freezing process. [12][13][14] As a result, it can be postulated that cryothermal ablation should result in a lower rate of ERAF because of the relatively reduced inflammatory reaction. 15,16 Interestingly, this was not observed in this prospective, randomized, multicenter study.…”

Understanding the ECG. Part 5: Pre-excitation

“…If a mild freeze halts AP conduction without inducing AV block, lower temperatures can be applied, resulting in a permanent lesion. The downside of this approach is a slightly higher rate of repeat ablation, however this may be preferable to a higher risk of pacemaker implantation (Andrade et al, 2013).…”