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Cryoablation of Medically Refractory Nodoventricular Tachycardia
Author(s) -
SILKA MICHAEL J.,
KRON JACK,
CUTLER JOEL E.,
WILSON RICHARD A.,
COBANOGLU ADNAN
Publication year - 1990
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1990.tb02128.x
Subject(s) - medicine , cryoablation , tachycardia , refractory (planetary science) , cardiology , ventricular tachycardia , dissection (medical) , ablation , surgery , physics , astrobiology
Paroxysmal wide QRS tachycardia, based on a nodoventricular accessory connection, is an uncommon arrhythmia. In this report, the endocardial and epicardial mapping and Cryoablation of a nodoventricular fiber, documented to participate in medically refractory tachycardia in an 11‐year‐old boy, are described. Epicardial cryothermia, applied at the earliest site of right ventricular activation, resulted in the abrupt termination of tachycardia. Endocardial cryothermia was subsequently applied in the perinodal region, the presumed site of origin of the nodoventricular fiber. No tachyarrhythmias were inducible postoperatively, and no antiarrhythmic treatment has been required during 18 months of follow‐up. Based on precise anatomic localization of the nodoventricular connection, a definitive cure of associated tachyarrhythmias may be possible utilizing cryothermia, without the requirement for extensive intraoperative dissection.