Endocardial Right and Left Ventricular Cryo Balloon Ablation as a Bailout Strategy for Refractory Ventricular Tachycardia

We report seven patients who underwent bail out cryoballoon ablation of ventricular arrhythmias refractory to conventional endocardial radiofrequency ablation. Ablated arrhythmia substrates included right ventricular moderator band (n=2), left ventricular (LV) papillary muscle (n=2), left fascicular (n=1) and deep LV myocardial (n=2). Cryoballoon ablation was successful in 5/7 patients. Advantages of cryoballon ablation include adhesive stability on endocavitary structures and creation deep homogeneous myocardial lesionds. Newer balloon technologies designed to improve myocardial contact that incorporate high density mapping on the balloon surface may expand utility of this technology for ablation of ventricular arrhythmias.