Epicardial Catheter Ablation Using High-Intensity Ultrasound

Nazer, Babak; Salgaonkar, Vasant A.; Diederich, Chris J.; Jones, Peter D.; Duggirala, Srikant; Tanaka, Yasuaki; Ng, Bennett K.; Sievers, Richard E.; Gerstenfeld, Edward P.

doi:10.1161/circep.115.003547

Cited by 13 publications

(8 citation statements)

References 22 publications

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“…A different ultrasonic technique using microbubbles to produce myocardial cavitation and enhance energy delivery extracorporeally is under investigation . Catheter‐based HIFU is also attractive given its ability to efficiently generate deeper and larger myocardial lesions than RF . While there have been no human studies to date in HCM, HIFU offers the potential for a completely non‐invasive septal reduction in the future.…”

Section: Novel Procedural Techniques For Hypertrophic Cardiomyopathymentioning

confidence: 99%

Hypertrophic cardiomyopathy: the future of treatment

Tuohy

Kaul

Song

et al. 2020

European J of Heart Fail

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131

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Hypertrophic cardiomyopathy (HCM) is a heterogeneous genetic disorder most often caused by sarcomeric mutations resulting in left ventricular hypertrophy, fibrosis, hypercontractility, and reduced compliance. It is the most common inherited monogenic cardiac condition, affecting 0.2% of the population. Whereas currently available therapies for HCM have been effective in reducing morbidity, there remain important unmet needs in the treatment of both the obstructive and non‐obstructive phenotypes. Novel pharmacotherapies directly target the molecular underpinnings of HCM, while innovative procedural techniques may soon offer minimally‐invasive alternatives to current septal reduction therapy. With the advent of embryonic gene editing, there now exists the potential to correct underlying genetic mutations that may result in disease. This article details the recent developments in the treatment of HCM including pharmacotherapy, septal reduction procedures, mitral valve manipulation, and gene‐based therapies.

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Section: Novel Procedural Techniques For Hypertrophic Cardiomyopathymentioning

confidence: 99%

Hypertrophic cardiomyopathy: the future of treatment

Tuohy

Kaul

Song

et al. 2020

European J of Heart Fail

Self Cite

131

View full text Add to dashboard Cite

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“…High-intensity ultrasound is an acoustic energy source able to deliver deep lesions through fat while sparing superficial structures. 19 This energy source is under consideration for application in both endocardial and epicardial ablation. Electroporation is another energy modality also currently being examined for use during epicardial ablation, but it has not yet been applied clinically.…”

Section: High-intensity Ultrasound and Electroporationmentioning

confidence: 99%

Patient Selection for Epicardial Ablation—Part II: The Epicardial Approach and Current Challenges Associated with Epicardial Ablation

Edward

Nguyen

2019

J Innov Cardiac Rhythm Manage

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Since their inception, percutaneous epicardial approaches have become increasingly common in clinical practice with the advent of new technology and the growth of catheter ablation for both ventricular and supraventricular arrhythmias. In addition to identifying the arrhythmogenic foci, there remain challenges to successful epicardial ablation such as the choice of energy source, optimizing irrigation during ablation, and anatomic barriers such as epicardial fat and coronary vessels. The performance of continued translational studies to understand how each of these factors contribute to lesion formation will be essential to guide future advances in the field of epicardial ablation.

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“…[68] The ability to perform ablation on deep tissue is valuable for VT ablation. [69] Although upfront an attractive option it has had issues since its first inception, particularly in AF ablations (endocardial approaches) and at present is not safe for everyday clinical use. [70]…”

Section: Ultrasoundmentioning

confidence: 99%

Irreversible electroporation for the treatment of cardiac arrhythmias

Sugrue

Maor

Ivorra

et al. 2018

Expert Review of Cardiovascular Therapy

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Cardiac ablation is an established treatment modality for the management of patients with cardiac arrhythmias. Current approaches to cardiac ablation employ thermal based energy to achieve lesions (damage) within the heart. There are many shortcomings and limitations of thermal based approaches. Electroporation (DC energy) is a non-thermal alternative approach to ablation that has shown significant promise in animal studies. Areas covered: An extensive review of the literature on the application of electroporation for ablation (both cardiac and collateral cardiac tissue) was undertaken. This review explores irreversible electroporation as a cardiac ablation modality. Specifically, it focuses and explains the biophysics of electroporation, the limitations of current thermal based approaches and examines the current data published on electroporation cardiac ablation. Expert commentary: Electroporation is a fast-growing novel ablation modality that has many advantages over current thermal based approaches. Current research in animal models shows its can be safely and efficaciously applied to the heart. Although further research is required, electroporation represents an appealing option for the ablation cardiac arrhythmias.

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Epicardial Catheter Ablation Using High-Intensity Ultrasound

Cited by 13 publications

References 22 publications

Hypertrophic cardiomyopathy: the future of treatment

Hypertrophic cardiomyopathy: the future of treatment

Patient Selection for Epicardial Ablation—Part II: The Epicardial Approach and Current Challenges Associated with Epicardial Ablation

Irreversible electroporation for the treatment of cardiac arrhythmias

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