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[Perinodal cryomodification for supraventricular tachycardia]
1Second Department of Surgery, Nippon Medical School, Tokyo, Japan.
Abstract:
The perinodal cryomodification procedure ablates the surrounding tissue of atrioventricular node, as a consequence, eliminates atrioventricular nodal reentrant tachycardia (AVNRT) and reduces the ventricular response during atrial fibrillation. We performed the procedure in 4 patients: 2 patients with AVNRT, 1 patient with atrioventricular reciprocating tachycardia utilizing a left side accessory pathway and atrioventricular node dual pathways, and 1 patient with tachycardic atrial fibrillation. The concomitant procedures include a closure of atrial septal defect and a mitral valve replacement. All the patients survived the procedure and cured the tachycardia. Post operative electrophysiological studies showed that the retrograde conduction over the atrioventricular node was eliminated while the antegrade conduction was preserved in the patients with atrioventricular node dual pathways. The perinodal cryomodification is a safe and effective procedure to cure the tachycardia, particularly in the patients with a structural heart disease.