?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.title=Cryothermal+Energy+Ablation+Of+Cardiac+Arrhythmias+2005%3A+State+Of+The+Art&rft.creator=De+Ponti%2C+Roberto&rft.subject=Indian+Pacing+and+Electrophysiology+Journal&rft.description=At+the+time+of+antiarrhythmic+surgery%2C+cryothermal+energy+application+by+a+hand-held+probe+was+used+to+complement+dissections+and+resections+and+permanently+abolish+the+arrhythmogenic+substrate.+Over+the+last+decade%2C+significant+engineering+advances+allowed+percutaneous+cryoablation+based+on+catheters%2C+apparently+not+very+different+from+standard+radiofrequency+ablation+catheters.+Cryothermal+energy+has+peculiar+characteristics.+In+fact%2C+it+allows+testing+in+a+reversible+way+the+effects+of+energy+application+at+higher+temperature%2C+before+producing+a+permanent+lesion+at+%E2%80%9375%C2%B0C.+Moreover%2C+slow+formation+of+the+lesion+allows+timely+discontinuation+of+the+application%2C+as+soon+as+inadvertent+modifications+of+normal+atrioventricular+conduction+are+observed+during+ablation+in+the+proximity+of+atrioventricular+node+and+His+bundle%2C+avoiding+its+permanent+damage.+Over+the+last+years%2C+percutaneous+cryothermal+ablation+has+been+widely+used+for+a+variety+of+cardiac+arrhythmias.+From+the+data+gathered%2C+it+is+unlikely+that+cryoablation+will+replace+standard+ablation+in+unselected+cases.+Nevertheless%2C+for+the+above+mentioned+peculiarities%2C+cryothermal+ablation+has+proved+very+effective+and+safe+for+ablation+of+arrhythmogenic+substrates+close+to+the+normal+conduction+pathways%2C+becoming+the+first+choice+method+to+ablate+anteroseptal+and+midseptal+accessory+pathways.+It+can+be+also+the+best+treatment+for+ablation+of+the+slow+pathway+to+abolish+atrioventricular+node+reentrant+tachycardia+in+pediatrics+or+when+particular+anatomy+of+the+Koch%E2%80%99s+triangle+is+observed.+Cryothermal+ablation+of+the+pulmonary+veins+for+atrial+fibrillation%2C+although+longer+than+radiofrequency+ablation%2C+is+not+associated+with+pulmonary+vein+stenosis+and+is+expected+to+be+less+thrombogenic%3B+new+catheter+designs+for+cryothermal+ablation+of+this+challenging+arrhythmia+are+to+be+tested+to+assess+their+efficacy+and+clinical+usefulness.+%0A&rft.publisher=Indian+Pacing+and+Electrophysiology+Group&rft.contributor=Singh%2C+Balbir&rft.contributor=Lokhandwala%2C+Yash&rft.contributor=Francis%2C+Johnson&rft.contributor=Gupta%2C+Anup&rft.date=2005-01&rft.type=Journal+(Paginated)&rft.type=PeerReviewed&rft.format=application%2Fpdf&rft.identifier=http%3A%2F%2Fcogprints.org%2F4170%2F1%2Fponti.pdf&rft.identifier=++De+Ponti%2C+Roberto++(2005)+Cryothermal+Energy+Ablation+Of+Cardiac+Arrhythmias+2005%3A+State+Of+The+Art.++%5BJournal+(Paginated)%5D+++++&rft.relation=http%3A%2F%2Fcogprints.org%2F4170%2F