Epicardial Treatment of Atrial Fibrillation Using Cryoablation in an Acute Off-pump Sheep Model

Doll, Nicolas; Kornherr, Patrick; Aupperle, H.; Fabricius, Alexander; Kiaii, Bob; Ullmann, C.; Schneider, Katja; Dhein, Stefan; Schoon, Heinz-Adolf; Rastan, Ardawan; Walther, Thomas; Mohr, Friedrich W.

doi:10.1055/s-2003-43086

Cited by 59 publications

(10 citation statements)

References 16 publications

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“…Cryoablation has produced transmural lesions in 25-100% of samples in beating-heart models with mean LA thickness of 2.0 ± 0.3mm [8]. Transmularity with microwave ablations has only been achieved in 20%-46% of samples in beating-heart animal models with mean LA thickness of 2.62 ± 1.31mm [9-11].…”

Section: Discussionmentioning

confidence: 99%

Reproducibility of left atrial ablation with high-intensity focused ultrasound energy in a calf model

Villamizar

Crow

Piacentino

et al. 2010

The Journal of Thoracic and Cardiovascular Surgery

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Purpose Achieving transmural tissue ablation may be necessary for successful treatment of atrial fibrillation. The purpose of this study is to evaluate the reproducibility of transmural left atrial (LA) ablation using a high intensity focused ultrasound (HIFU) energy system in a calf model. Methods Nine heparinized bovines underwent a beating-heart LA ablation with a single application of the HIFU device. All animals were acutely sacrificed and the LA was fixed in formalin. Protocolized histological sections (5μm) were obtained throughout each lesion and prepared with Masson's Trichrome and Hematoxylin and Eosin staining. Measurements were performed on a total of 359 slides from the nine lesions. In addition, fresh LA from 18 unused human donor hearts that did not meet criteria for cardiac transplantation were measured at the site where the HIFU device is normally applied. Results Calf LA thickness ranged between 2.5 and 20.1 mm, with a mean of 9.10 mm. HIFU ablation consistently produced a 100% transmural lesion in LA thickness up to 6mm. In addition, a transmural lesion was observed in 91% of tissues that were up to 10 mm thick and in 85% up to 15 mm of thickness. Human LA thickness ranged between 1.2 to 6 mm, with a mean of 3.7 mm. Conclusions Calf LA thickness in this study was greater than human LA thickness. Human LA thickness is generally less than 6mm, and in this range HIFU ablation achieved 100% transmurality. These histological results may correlate with a high success rate of atrial fibrillation ablation using the HIFU system.

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Section: Discussionmentioning

confidence: 99%

Reproducibility of left atrial ablation with high-intensity focused ultrasound energy in a calf model

Villamizar

Crow

Piacentino

et al. 2010

The Journal of Thoracic and Cardiovascular Surgery

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“…1162,1291,1292 Moreover, both unipolar and directional bipolar energy sources have had difficulty creating transmural lesions when used from the epicardial surface on the beating heart. 1293,1294,1295,1296,1297,1298 This difficulty occurs because the circulating intracavitary blood pool produces convective cooling, which makes transmural lesions difficult to achieve. 1299 In an attempt to obviate this problem, one device provides suction to pull two walls of atrial tissue into apposition in a shallow trough, thus excluding the circulating heat sink of intracavitary blood while the energy is applied.…”

Section: Section 12: Surgical and Hybrid Af Ablationmentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

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1,468

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“…Over the next decade, this operation became the gold standard for the surgical treatment of AF. 1–4 The 10 year freedom from AF in our series has been 96%. These excellent results have been reproduced by other groups around the world.…”

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confidence: 64%

Ablation Technology for the Surgical Treatment of Atrial Fibrillation

Melby

Schuessler²,

Damiano³

2013

ASAIO Journal

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The Cox maze procedure for the surgical treatment of atrial fibrillation has been simplified from its original cut-and-sew technique. Various energy sources now exist which create linear lines of ablation that can be used to replace the original incisions, greatly facilitating the surgical approach. This review article describes the anatomy of the atria that must be considered in choosing a successful energy source. Furthermore the device characteristics, safety profile, mechanism of tissue injury, and ability to create transmural lesions of the various energy sources that have been used in the Cox maze procedure, along with the strengths and weaknesses of each device is discussed.

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Epicardial Treatment of Atrial Fibrillation Using Cryoablation in an Acute Off-pump Sheep Model

Abstract: Epicardial cryoablation is not effective on thicker tissues like LAA and RAA due to the rewarming of the current blood flow. However, thin tissues like VCC and PV can be isolated. Further chronic studies are necessary to evaluate the potential for regeneration of adjacent structures.

Cited by 59 publications

References 16 publications

Reproducibility of left atrial ablation with high-intensity focused ultrasound energy in a calf model

Reproducibility of left atrial ablation with high-intensity focused ultrasound energy in a calf model

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Ablation Technology for the Surgical Treatment of Atrial Fibrillation

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