Evaluation of a new epicardial cryoablation system for the treatment of Cardiac Tachyarrhythmias

Baust, John M.; Robilotto, Anthony T.; Snyder, Kristi K.; Buskirk, Robert Van; Baust, John G.

doi:10.15761/tim.1000125

Cited by 2 publications

(2 citation statements)

References 38 publications

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“…Due to the increased heat capacity of the SCN cryogen compared to argon and nitrous oxide cryogens, SCN also offers the potential to deliver ablative doses deep into tissue while exposed to high heat loads such as experienced in the beating heart. 21 , 44 , 47 , 52 Given the potential of this system, in this study, we utilized a series of ex vivo bench test models to assess and characterize the performance of this system. Furthermore, these studies were designed to provide a series of bench testing models which could potentially be utilized to provide a reference data set for pre-clinical and clinical study development and protocol optimization.…”

Section: Discussionmentioning

confidence: 99%

Assessment of a novel cryoablation device for the endovascular treatment of cardiac tachyarrhythmias

et al. 2018

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Objectives:Cryoablation is an effective alternative treatment for cardiac arrhythmias offering shortened recovery and reduced side effects. As the use of cryoablation increases, the need for new devices and procedures has emerged. This has been driven by technological limitations including lengthy periods to generate a single lesion (3–5 min), uncertain transmurality, and differential efficacy. Furthermore, due to limited ablation capacity under high heat loads, cryo has had limited success in the treatment of ventricular arrhythmias. To this end, in this study we evaluated a new cryoablation catheter, ICEolate, for the targeted ablation of cardiac tissue.Methods:Performance assessment included calorimetry, freeze zone isothermal distribution characterization and catheter ablation capacity in a submerged, circulating, heat-loaded ex vivo tissue model. A pilot in vivo study was also conducted to assess ablative capacity of the cryocatheter in a fully beating heart.Results:Ex vivo studies demonstrated ice formation at the tip of a cryocatheter within 5 s and a tip temperature of ~−150°C within 10 s. The device repeatedly generated freeze zones of 2 cm × 3 cm in less than 2 min. Tissue model studies revealed the generation of a full thickness (5–10 mm) cryogenic lesion within 1 min with an opposite (transmural) surface temperature of <−60°C under a circulating 37°C heat load. Pilot in vivo studies demonstrated the delivery of an ablative “dose,” producing a continuous full thickness transmural linear lesion in <60 s at both atrial and ventricular sites.Conclusion:These studies suggest that the supercritical nitrogen cryodevice and ICEolate cryocatheter may provide for rapid, effective, controllable freezing of targeted tissue. The ablative power, speed, and directional freeze characteristics also offer the potential of improved safety via a reduction in procedural time compared to current cryoablation devices. These technological developments may open new avenues for the application of cryo to treat other cardiac arrhythmogenic disorders.

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Section: Discussionmentioning

confidence: 99%

Assessment of a novel cryoablation device for the endovascular treatment of cardiac tachyarrhythmias

et al. 2018

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“…Cryoablation is not as commonly used, despite being found to significantly reduce the surface area of GPs, with the SL and ARGPs most dramatically reduced overall [ 108 ]. However, with increased reports of its efficacy in treating AF, interest is growing in cryoablation as a stand-alone ablation modality and in the development of cryoablation devices [ 109 ]. Cryoablation can also be used in conjunction with RF to target GPs and achieve PVI [ 107 , 108 ].…”

Section: Gp Ablation For Afmentioning

confidence: 99%

Ganglionated Plexi Ablation for the Treatment of Atrial Fibrillation

Avazzadeh

McBride

O’Brien³

et al. 2020

JCM

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Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and is associated with significant morbidity and mortality. The autonomic nervous system (ANS) plays an important role in the initiation and development of AF, causing alterations in atrial structure and electrophysiological defects. The intrinsic ANS of the heart consists of multiple ganglionated plexi (GP), commonly nestled in epicardial fat pads. These GPs contain both parasympathetic and sympathetic afferent and efferent neuronal circuits that control the electrophysiological properties of the myocardium. Pulmonary vein isolation and other cardiac catheter ablation targets including GP ablation can disrupt the fibers connecting GPs or directly damage the GPs, mediating the benefits of the ablation procedure. Ablation of GPs has been evaluated over the past decade as an adjunctive procedure for the treatment of patients suffering from AF. The success rate of GP ablation is strongly associated with specific ablation sites, surgical techniques, localization techniques, method of access and the incorporation of additional interventions. In this review, we present the current data on the clinical utility of GP ablation and its significance in AF elimination and the restoration of normal sinus rhythm in humans.

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Evaluation of a new epicardial cryoablation system for the treatment of Cardiac Tachyarrhythmias

Cited by 2 publications

References 38 publications

Assessment of a novel cryoablation device for the endovascular treatment of cardiac tachyarrhythmias

Assessment of a novel cryoablation device for the endovascular treatment of cardiac tachyarrhythmias

Ganglionated Plexi Ablation for the Treatment of Atrial Fibrillation

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