title: Cryocatheter ablation of right ventricular outflow tract tachycardia.
abstract: BACKGROUND
  Cryocatheter techniques have been successfully applied to treat supraventricular tachycardia but there are no reports on their value in treating ventricular tachycardia (VT). We present our initial experience with cryocatheter ablation of right ventricular outflow tract (RVOT) tachycardia.
  
  
  RESULTS
  Cryocatheter ablation was attempted in 14 patients (13 females, age 45.9 +/- 12.7 years) who were highly symptomatic due to frequent monomorphic ventricular extrasystole (VES) or nonsustained VT originating within the RVOT. A 9-Fr, 8-mm-tip cryocatheter was used for both mapping and ablation. Cryoablation was started after localizing the arrhythmic focus by pace and activation mapping. Ablation success, defined by complete disappearance of target VES/VT acutely and during a follow-up of 9.3 +/- 1.4 weeks, was achieved in 13 of 14 patients. Ablation was successful with local activation times of 35 +/- 4 ms, 5.8 +/- 3.3 applications, 18.8 +/- 7.5 minutes total cryo time, 9.4 +/- 4.2 minutes fluoroscopy time, and 66.9 +/- 26.1 minutes total procedure time, the latter two measures showing a reduction with number of patients treated. Three patients reported slight pain related to local pressure of the catheter on the RVOT wall. No pain was described related to delivery of cryothermal energy.
  
  
  CONCLUSIONS
  Initial experience shows that focal VES/VT originating in the RVOT can be successfully treated using cryocatheter ablation. Acute and short term success rates, fluoroscopy times, and duration of procedure are comparable to conventional ablation techniques. A major advantage seems to be the virtual absence of ablation related pain.
authors.affiliation: Kerckhoff-Klinik, Department of Cardiology, Bad Nauheim, Germany. k.kurzidim@kerckhoff-klinik.de <k.kurzidim@kerckhoff-klinik.de>
authors.forename: Klaus
authors.initials: K
authors.lastname: Kurzidim
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Schneider
authors.forename: Malte
authors.initials: M
authors.lastname: Kuniss
authors.forename: Johannes
authors.initials: J
authors.lastname: Sperzel
authors.forename: Harald
authors.initials: H
authors.lastname: Greiss
authors.forename: Alexander
authors.initials: A
authors.lastname: Berkowitsch
authors.forename: Heinz Friedrich
authors.initials: HF
authors.lastname: Pitschner
mesh_terms: D000328:Adult; D000368:Aged; D018780:Body Surface Potential Mapping; D003452:Cryosurgery / Q000379:methods; D015716:Electrocardiography, Ambulatory; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery*; D006339:Heart Rate / Q000502:physiology; D006352:Heart Ventricles / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome