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Peer-reviewedCC BY-NC-NDInternal Medicine

Challenges and Strategies in Cryoablation of Para-Hisian Ventricular Arrhythmia: Insights from Two Intractable Cases

  • Tadashi Hoshiyama
  • Kohei Matsunaga
  • Shinsuke Hanatani
  • Hitoshi Sumi
  • Shozo Kaneko
  • Hisanori Kanazawa
  • Yuichiro Tsuruta
  • Kenichi Tsujita
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Abstract

The use of the Freezor Xtra catheter (Medtronic, Minneapolis, USA) is preferred for atrioventricular nodal reentrant tachycardia owing to its low atrioventricular block risk. Therefore, use of this catheter is occasionally applied to para-Hisian ventricular arrhythmia (VA). However, the tips for catheter use in intractable cases remain challenging. This report consists of two cases of drug-resistant VAs originating from para-His. Case 1 involved a 76-year-old man who was treated VA using the reverse bending catheter technique. Case 2 involved 59-year-old man with VA who was treated at the earliest left ventricular activation site using a transseptal approach. These cases highlight the practical strategies for challenging para-His VA cases.

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Cite

BibTeXRIS
BibTeX
@article{hoshiyama2026challenges,
  title = {{Challenges and Strategies in Cryoablation of Para-Hisian Ventricular Arrhythmia: Insights from Two Intractable Cases}},
  author = {Tadashi Hoshiyama and Kohei Matsunaga and Shinsuke Hanatani and Hitoshi Sumi and Shozo Kaneko and Hisanori Kanazawa and Yuichiro Tsuruta and Kenichi Tsujita},
  journal = {Internal Medicine},
  year = {2026},
  month = jul,
  doi = {10.2169/internalmedicine.6434-25},
  url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/14/65_6434-25/_article},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Challenges and Strategies in Cryoablation of Para-Hisian Ventricular Arrhythmia: Insights from Two Intractable Cases
AU  - Tadashi Hoshiyama
AU  - Kohei Matsunaga
AU  - Shinsuke Hanatani
AU  - Hitoshi Sumi
AU  - Shozo Kaneko
AU  - Hisanori Kanazawa
AU  - Yuichiro Tsuruta
AU  - Kenichi Tsujita
PY  - 2026
DA  - 2026/07/15
JO  - Internal Medicine
DO  - 10.2169/internalmedicine.6434-25
UR  - https://www.jstage.jst.go.jp/article/internalmedicine/65/14/65_6434-25/_article
AB  - The use of the Freezor Xtra catheter (Medtronic, Minneapolis, USA) is preferred for atrioventricular nodal reentrant tachycardia owing to its low atrioventricular block risk. Therefore, use of this catheter is occasionally applied to para-Hisian ventricular arrhythmia (VA). However, the tips for catheter use in intractable cases remain challenging. This report consists of two cases of drug-resistant VAs originating from para-His. Case 1 involved a 76-year-old man who was treated VA using the reverse bending catheter technique. Case 2 involved 59-year-old man with VA who was treated at the earliest left ventricular activation site using a transseptal approach. These cases highlight the practical strategies for challenging para-His VA cases.
SN  - 1349-7235
SN  - 0918-2918
ER  -