Cryoablation of an atrioventricular nodal reentrant tachycardia in a patient with an implanted deep brain stimulator  Melanie Gunawardene, MD, Christian.

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Cryoablation of an atrioventricular nodal reentrant tachycardia in a patient with an implanted deep brain stimulator  Melanie Gunawardene, MD, Christian Meyer, Stephan Willems, Boris Alexander Hoffmann, MD  HeartRhythm Case Reports  Volume 2, Issue 3, Pages 258-260 (May 2016) DOI: 10.1016/j.hrcr.2016.02.003 Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 1 Fluoroscopic view of the ablation setting. Left: Positioning the cryocatheter at the location of the slow pathway in the Koch triangle with the different diagnostic catheters positioned at the high right atrium (HRA), right ventricle (RV), His bundle (His), and coronary sinus (CS). Right: Neurostimulator implanted in the left upper chest. HeartRhythm Case Reports 2016 2, 258-260DOI: (10.1016/j.hrcr.2016.02.003) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 2 Intracardiac electrogram showing the patient’s clinical tachycardia as a typical slow–fast atrioventricular nodal reentrant tachycardia (133 beats/min, cycle length 450 ms). A = atrial signal; H = signal of the His bundle; V = ventricular signal. HeartRhythm Case Reports 2016 2, 258-260DOI: (10.1016/j.hrcr.2016.02.003) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 3 Temperature curve of the first cryoablation application showing the mapping mode at –30°C (1) and the actual ablation with a minimum temperature of –79°C (2). HeartRhythm Case Reports 2016 2, 258-260DOI: (10.1016/j.hrcr.2016.02.003) Copyright © 2016 Heart Rhythm Society Terms and Conditions