Atrioventricular nodal ablation and biventricular pacing therapy with coronary venoplasty for severe heart failure with drug refractory atrial tachycardia.

A 53-year-old man was admitted to our hospital for dyspnea, associated with atrial tachycardia. He underwent mitral valve replacement and Maze operation for mitral regurgitation and atrial fibrillation and since then he suffered from drug refractory atrial tachycardia followed by cardiogenic shock with systolic heart failure. Atrial tachycardia with rapid ventricular response was medically refractory, and radical catheter ablation was thought to be very difficult due to post Maze operation, mitral mechanical valve replacement and unstable hemodynamics.

Atrial fibrillation ablation with esophageal cooling with a cooled water-irrigated intraesophageal balloon: a pilot study.

Introduction: A left atrioesophageal fistula is an uncommon but devastating complication that may occur during atrial fibrillation (AF) ablation, and may be due to thermal injury occurring during the radiofrequency (RF) ablation. We examined the feasibility of an esophageal cooling (ECO) method using a cooled water-irrigated intraesophageal balloon (IB).

Methods And Results: Eight patients with drug-refractory AF underwent RF catheter ablation to encircle the ipsilateral pulmonary veins.