Histopathology of intraoperatively induced linear radiofrequency ablation lesions in patients with chronic atrial fibrillation

Abstract

Intraoperative cooled-tip ablation in AF resulted in coagulation necrosis of endocardium, subendocardium, and the atrial myocardial layer to a depth of 5.5 mm bordered by an irregular zone of incomplete thermal damage. Transmurality of the lesions could only be found in 75% of intraoperatively applied lesions.

Early Recurrence After Pulmonary Vein Isolation of Paroxysmal Atrial Fibrillation With Different Ablation Technologies – Prospective Comparison of Radiofrequency vs. Second-Generation Cryoballoon Ablation –

“…Inflammatory reactions around the injury sites, with infiltration of inflammatory cells, have been found in histopathologic studies. [20][21][22] In the RF group, the hs-CRP value post-procedure did not correlate with the total amount of RF energy delivered, presumably because the inflammatory reaction differs among individual patients and the amount of tissue injury is defined by several parameters, such as the contact force. Cryothermal tissue injury was found to be distinguished from hyperthermic injury by less inflammation through preservation of the basic underlying tissue architecture and minimal thrombus formation.…”

Potentials, Limitations and Future Directions of MR Contrast Media in Ablation Therapies

“…Deneke et al [89] sampled 59 lesions at the time of intraoperative cooled tip RF catheter ablation and found lack of transmurality in 25% of all lesions. Accord et al [90] reported the histological findings in 3 patients who died 2 to 22 days after intraoperative epicardial microwave ablation for pulmonary vein isolation.…”

Immunohistochemical identification of stent-based ablation lesions in the superior vena cava and pulmonary veins

“…Different histological staining techniques for chronic lesions have been described, such as masson trichrome, hematoxylin and eosin, and elastic-van Gieson stains [6][7][8][9].…”