PMID- 30603856
OWN - NLM
STAT- MEDLINE
DCOM- 20200109
LR  - 20200225
IS  - 1572-8595 (Electronic)
IS  - 1383-875X (Linking)
VI  - 55
IP  - 1
DP  - 2019 Jun
TI  - Efficacy and safety of cryoablation of para-Hisian and mid-septal accessory 
      pathways using a specific protocol: single-center experience in consecutive 
      patients.
PG  - 47-54
LID - 10.1007/s10840-018-0498-9 [doi]
AB  - PURPOSE: Radiofrequency (RF) catheter ablation of para-Hisian (P-H) and 
      mid-septal (M-S) accessory pathways (APs) is a potentially harmful procedure due 
      to their close location to the A-V node. Conversely, cryoablation (CA) appears 
      safer in this setting. The aim of this study was to assess the efficacy and 
      safety of CA of these APs using a specific protocol. METHODS: Fifty-three 
      patients undergoing CA for P-H (45) or M-S (8) APs were included. CA was 
      performed with a 4-mm catheter at - 75  degrees C for 480 s in the site where conduction 
      block over the AP was obtained by a specific cryomapping protocol. Optimal 
      catheter-tissue contact was achieved by inferior or superior vena cava approach. 
      In case of failure, a 6-mm catheter and/or trans-septal catheterization (TSC) 
      were considered. Normal AV conduction was monitored throughout CA, which was 
      interrupted in case of its inadvertent modifications. RESULTS: In 46 patients 
      (87%), CA was successful. Reasons for failure were as follows: lack of AP 
      interruption (3 patients), intraprocedure AP conduction resumption (3), or 
      transient A-H interval prolongation (1). Failure was associated with more 
      aggressive approach including multiple procedures, greater use of 6-mm catheters, 
      TSC, and longer CA applications. No major complications were observed. Three out 
      of 46 patients (6.5%) experienced relapse of AP conduction during follow-up and 
      were successfully re-treated by CA. CONCLUSIONS: CA of P-H and M-S APs is highly 
      safe and effective and a specific protocol for cryomapping and CA could lead to a 
      low recurrence rate at follow-up.
FAU - Marazzato, Jacopo
AU  - Marazzato J
AUID- ORCID: 0000-0003-1205-5925
AD  - Department of Heart and Vessels, Ospedale di Circolo e Fondazione Macchi, 
      University of Insubria, Viale Borri, 57, 21100, Varese, Italy. 
      j.marazzato88@gmail.com.
FAU - Fonte, Giuseppe
AU  - Fonte G
AD  - Department of Heart and Vessels, Ospedale di Circolo e Fondazione Macchi, 
      University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
FAU - Marazzi, Raffaella
AU  - Marazzi R
AD  - Department of Heart and Vessels, Ospedale di Circolo e Fondazione Macchi, 
      University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
FAU - Doni, Lorenzo A
AU  - Doni LA
AD  - Department of Heart and Vessels, Ospedale di Circolo e Fondazione Macchi, 
      University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
FAU - Mitacchione, Gianfranco
AU  - Mitacchione G
AD  - Department of Heart and Vessels, Ospedale di Circolo e Fondazione Macchi, 
      University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
FAU - Vilotta, Manola
AU  - Vilotta M
AD  - Department of Heart and Vessels, Ospedale di Circolo e Fondazione Macchi, 
      University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
FAU - De Ponti, Roberto
AU  - De Ponti R
AD  - Department of Heart and Vessels, Ospedale di Circolo e Fondazione Macchi, 
      University of Insubria, Viale Borri, 57, 21100, Varese, Italy.
LA  - eng
PT  - Journal Article
DEP - 20190103
PL  - Netherlands
TA  - J Interv Card Electrophysiol
JT  - Journal of interventional cardiac electrophysiology : an international journal of 
      arrhythmias and pacing
JID - 9708966
SB  - IM
MH  - Accessory Atrioventricular Bundle/*surgery
MH  - Adolescent
MH  - Adult
MH  - Bundle of His/*surgery
MH  - Child
MH  - Cryosurgery/*methods
MH  - Female
MH  - Heart Septum/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Safety
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Accessory pathways
OT  - Catheter ablation
OT  - Cryoablation
OT  - Cryomapping
OT  - Wolff-Parkinson-White syndrome
EDAT- 2019/01/04 06:00
MHDA- 2020/01/10 06:00
CRDT- 2019/01/04 06:00
PHST- 2018/08/29 00:00 [received]
PHST- 2018/12/17 00:00 [accepted]
PHST- 2019/01/04 06:00 [pubmed]
PHST- 2020/01/10 06:00 [medline]
PHST- 2019/01/04 06:00 [entrez]
AID - 10.1007/s10840-018-0498-9 [pii]
AID - 10.1007/s10840-018-0498-9 [doi]
PST - ppublish
SO  - J Interv Card Electrophysiol. 2019 Jun;55(1):47-54. doi: 
      10.1007/s10840-018-0498-9. Epub 2019 Jan 3.