PT  - JOURNAL ARTICLE
AU  - J A Gaer
AU  - L Gordon
AU  - J Wharton
AU  - J M Polak
AU  - K M Taylor
AU  - W McKenna
AU  - D J Parker
TI  - Intractable chest pain in cardiomyopathy: treatment by a novel technique of cardiac cryodenervation with quantitative immunohistochemical assessment of success.
AID  - 10.1136/hrt.70.6.574
DP  - 1993 Dec 01
TA  - British Heart Journal
PG  - 574--577
VI  - 70
IP  - 6
4099  - http://heart.bmj.com/content/70/6/574.short
4100  - http://heart.bmj.com/content/70/6/574.full
SO  - Heart1993 Dec 01; 70
AB  - A novel method of cardiac denervation by cryoablation has been developed experimentally. The technique uses liquid nitrogen delivered under pressure to ablate the principal sources of cardiac innervation--namely, the adventitia surrounding the aorta, pulmonary arteries, and veins. The technique has been verified experimentally both in vivo by physiological means and in vitro by quantitative immunohistochemistry and the measurement of myocardial noradrenaline concentrations. A 35 year old woman presented with intractable precordial pain, normal epicardial coronary arteries, and hypertrophic cardiomyopathy. Her symptoms were refractory to maximal medical treatment and she was thought to be unsuitable for either conventional myocardial revascularisation, autotransplantation, or allografting with the concomitant risk of transplant coronary artery disease. She therefore underwent cardiac denervation by the method developed in the laboratory. There was quantitative immunohistochemical evidence of extrinsic cardiac denervation associated with a considerable improvement in her symptoms. This improvement persisted during a follow up period of over 16 months.