Cryosurgical treatment of atrial tachyarrhythmia with atrial flutter

: Two cases of atrial tachyarrhythmias with atrial flutter requiring cryosurgical treatment are reported. In two cases, preoperative electrophysiological studies revealed supraventricular reentrant tachyarrhythmias during atrial flutter and showed enhanced conduction through the AV node that conducted atrial impulses rapidly to the ventricle. Based on intraoperative endocardial mapping, the earliest excitation site was localized along the AV node and His bundle during supraventricular tachyarrhythmias in one case. The cryosurgical treatment was administered at Koch's triangles and in one case additionally at coronary sinus. After the operation, supraventricular tachyarrhythmias were not inducible and no clinical recurrences have occurred. Normal atrioventricular conduction was preserved in two cases. We concluded that cryosurgical treatment is useful for the treatment of the atrial tachyarrhythmias.