Cryoablation: potentials and pitfalls.

The use of cryoablation in the electrophysiology lab provides some distinct advantages not seen with conventional radiofrequency ablation. Ice mapping allows a functional assessment of a putative ablation site prior to the formation of a permanent lesion. This provides a distinct advantage adjacent to the AV node for para-hisian pathways and difficult cases of AVNRT. Cryoablation also produces minimal endothelial disruption and thrombus formation and causes no collagen shrinkage. This is likely advantageous when ablation is required within venous structures. There is also mounting experimental evidence that cryoablation is safe adjacent to the arterial system, especially within the middle cardiac vein or distal coronary sinus. As the technology evolves and further iterations of the catheter proceed, the role for this new but well-established technology is likely to grow.