Robotic Assisted Cryosurgical Treatment of Atrioventricular Node Reentrant Tachycardia
Atrioventricular nodal reentrant tachycardias (AVNRT) typically arise from the existence of variable refractoriness in fast and slow conduction pathways between the atrium and ventricle. A 65-year-old gentleman presented with several years of AVNRT. Despite medical management and attempted percutaneous ablation, the patient remained symptomatic with weekly episodes of AVNRT. Four centimeter right anterolateral thoracotomy access was used with peripheral perfusion. The da Vinci S robotic system was used to manipulate the cryoprobe. A series of spot freezes (tip 60oC) were made along the boundaries of the triangle of Koch until transient complete heart block was achieved and nodal rhythm was recovered.
Eric J. Lehr, MD, PhD
Innovations:Technology and Techniques in Cardiothoracic and Vascular Surgery. 6(2):126-128, March/April 2011