Feasibility of electroporation for the creation of pulmonary vein ostial lesions.

INTRODUCTION: There is an obvious need for a better energy source for pulmonary vein (PV) antrum isolation. OBJECTIVE: We investigated the feasibility and safety of electroporation for the creation of PV ostial lesions. METHODS: After transseptal puncture, a custom 7F decapolar 20 mm circular ablation catheter was placed in the PV ostia of 10 pigs. Ablation was performed with a nonarcing, 200 J application delivered between the catheter and an indifferent patch electrode on the lower back. A single pulse was applied for each catheter position, with a maximum of 4 per ostium. Local PV electrogram amplitude and stimulation threshold were measured at multiple locations in both ostia before and directly after ablation, and after 3 weeks survival, using a regular 4 mm mapping catheter. All PV ostia were sectioned, stained, and histologically investigated. RESULTS: The 3-week survival period was uneventful. PV ostial electrogram amplitude decreased and stimulation threshold increased significantly in most ostia. PV angiograms did not show any stenosis during this short follow-up. Histologically, up to 3.5-mm-deep lesions were found. CONCLUSION: Data suggest that electroporation can safely be used to create lesions in a sensitive environment like PV ostia.

Briefly occlusive coronary anastomosis with tissue adhesive.

OBJECTIVE: We assessed the feasibility of a facilitated, briefly occlusive, sutureless coronary anastomosis technique in which side-to-side preglued (octylcyanoacrylate adhesive) bounded walls were opened by a conventional arteriotomy. METHODS: In low-flow (prothrombotic milieu,