The initial observations of arrhythmogenic activity in the pulmonary veins (PVs) with the potential for triggering atrial fibrillation accounted for extensive investigation for more than a decade. Electrical isolation of…
Key Points • Liquid nitrogen is a difficult cryogen to pump through small channels because its massive volume expansion to nitrogen gas upon evaporation causes “vapor lock” or obstruction to…
Key Points • Precooling of N 2 O just before it enters the balloon catheter increases its cooling power. • The elongated shape of the cryoballoon optimizes tissue contact and…
Key Points • Cryoablation has an excellent safety profile in the septal region due to: 1 Reversibility of electrophysiologic effects at −30° (cryomapping). 2 Reversibility of electrophysiologic effects at −80°…
Key Points • Esophageal ulceration after atrial fibrillation (AF) ablation is associated with transmural atrial and esophageal necrosis with all energy sources, such as radiofrequency (RF), high-intensity focused ultrasound (HIFU),…
Key Points • Cryomapping may be performed during −30°C applications maintained for less than 60 seconds (classic cryomapping) or at the onset of −80°C applications (dynamic cryomapping). • During −80°C…
Key Points • Conventional electrophysiology cryoablation catheters do not cause significant damage to coronary vessels, although direct epicardial applications can potentially result in intimal hyperplasia. • Coronary spasm can be…
Key Points • Fundamental scientific concepts and pioneering technologic developments have made safe and effective percutaneous cryoablation possible. • Scientific concepts regarding thermal energy, heat transfer, and refrigeration techniques, and…
Key Points • The concept of using cryoenergy to treat medical illness has been present since the dawn of recorded history. • Specific application of cryoenergy as a therapeutic modality…
Key Points • Cryodestruction occurs through two primary mechanisms: immediate and delayed injury. • The use of low temperature as a thermal therapy provides a mode of transient injury that…
