Feasibility of directional percutaneous epicardial ablation with a partially insulated catheter.
J Interv Card Electrophysiol
; 53(1): 105-113, 2018 Oct.
Article
en En
| MEDLINE
| ID: mdl-30008046
ABSTRACT
PURPOSE:
To demonstrate the feasibility of directional percutaneous epicardial ablation using a partially insulated catheter.METHODS:
Partially insulated catheter prototypes were tested in 12 (6 canine, 6 porcine) animal studies in two centers. Prototypes had interspersed windows to enable visualization of epicardial structures with ultrasound. Epicardial unipolar ablation and ablation between two electrodes was performed according to protocol (5-60 W power, 0-60 mls/min irrigation, 78 s mean duration).RESULTS:
Of 96 epicardial ablation attempts, unipolar ablation was delivered in 53.1%. Electrogram evidence of ablation, when analyzable, occurred in 75 of 79 (94.9%) therapies. Paired pre/post-ablation pacing threshold (N = 74) showed significant increase in pacing threshold post-ablation (0.9 to 2.6 mA, P < .0001). Arrhythmias occurred in 18 (18.8%) therapies (11 ventricular fibrillation, 7 ventricular tachycardia), mainly in pigs (72.2%). Coronary artery visualization was variably successful. No phrenic nerve injury was noted during or after ablation. Furthermore, there were minimal pericardial changes with ablation.CONCLUSIONS:
Epicardial ablation using a partially insulated catheter to confer epicardial directionality and protect the phrenic nerve seems feasible. Iterations with ultrasound windows may enable real-time epicardial surface visualization thus identifying coronary arteries at ablation sites. Further improvements, however, are necessary.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Nervio Frénico
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Taquicardia Ventricular
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Ablación por Catéter
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Diseño de Equipo
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Complicaciones Intraoperatorias
Tipo de estudio:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Idioma:
En
Revista:
J Interv Card Electrophysiol
Asunto de la revista:
CARDIOLOGIA
Año:
2018
Tipo del documento:
Article