In 1968 Cobb, Sealy, and others1 reported the first surgical interruption of a pathway responsible for the Wolff-Parkinson-White (WPW) syndrome. Many successes followed. Using a Maze procedure, Cox surgically interrupted macroreentry circuits responsible for atrial fibrillation. Today, catheter-based ablations have largely replaced heart surgery to treat these conditions. The purpose of this essay is to describe the earliest consideration and uses of cryoablation.In 1921, it was noted that in isolated heart tissue, reducing the temperature slowed the rate of impulse formation and the speed of impulse transmission.2 In 1964, Lister reported that cooling the sinus node or the bundle of His reversibly slowed the pacemaker and AV conduction.3 These were the earliest descriptions of the effects of hypothermia on specialized tissues of the heart.
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