Low-energy transvenous ablation of the canine atrioventricular conduction system with a suction electrode catheter.

Saksena, Sanjeev; Tarján, P.; Bharati, Saroja; Boveja, Birinder; Cohen, Donald M.; Joubert, T; Lev, Maurice

doi:10.1161/01.cir.76.2.394

Cited by 23 publications

(1 citation statement)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Group 1 (10 dogs) received RF energy with a fixed power setting (5 or 10 W) while increasing the pulse duration from 10 to 50 seconds (10,15,20,30,40, and 50 seconds) for each application of RF energy until reaching one of the end points as described herein (Figure 1). Group 2 (10 dogs) received energy with a fixed pulse duration (20 or 30 seconds) while increasing power setting from 5 to 10 W (Figure 2) or from 10 to 20 W during each energy delivery until one of the following end points was attained.…”

Section: Ablation Protocolmentioning

confidence: 99%

Chronic incomplete atrioventricular block induced by radiofrequency catheter ablation.

et al. 1989

Self Cite

View full text Add to dashboard Cite

To determine if catheter ablation of the atrioventricular (AV) junction with radiofrequency energy can induce chronic incomplete (first-and second-degree) AV block to avoid the need for a permanent pacemaker, 20 closed-chest dogs were studied. Group 1 (10 dogs) received radiofrequency energy (750 kHz) with a fixed power setting (5 or 10 W) while increasing the pulse duration from 10 to 50 seconds for each application. Group 2 (10 dogs) received energy with a fixed pulse duration (20 or 30 seconds) while increasing the power setting from 5 to 10 W or from 10 to 20 W during each energy delivery. Radiofrequency energy was delivered between a chest-patch electrode and the distal electrode of a regular 7F tripolar His bundle catheter. For each application, the energy delivery was interrupted when 1) the PR interval prolonged (>50%) or 2) second-degree or complete AV block occurred and persisted up to 5 seconds. The ablation procedure ended when there was 1) persistent PR prolongation (>50%) or persistent second-degree AV block (lasting >30 minutes) after ablation, 2) occurrence of two consecutive transient (<1 minute) complete AV blocks after each energy delivery, or 3) complete AV block (lasting >2 minutes) after ablation. Of seven dogs in group 1 and five dogs in group 2 in which incomplete AV block was achieved 1 hour after the procedure, six in group 1 and five in group 2 remained in incomplete AV block 2-3 months after ablation. One dog in group 1 progressed into complete AV block. Of the remaining three dogs in group 1 and five dogs in group 2 in which complete AV block was initially achieved 1 hour after ablation, two in group 1 and four in group 2 continued to have complete AV block, whereas one in each group had AV conduction returned to incomplete at 1-2 months of follow-up. Thus, a total of 13 dogs had chronic incomplete AV block induced by radiofrequency catheter ablation. Pathologic examination of the conduction system in two dogs with first-degree AV block, two dogs with second-degree AV block, and one dog with complete AV block showed discrete scars involving the approaches to the AV node and the AV node itself. It is concluded that, in most dogs studied, chronic incomplete AV block could be achieved by careful titration of the dosage of radiofrequency energy and by regulation of the ablation end points. (Circulation 1989;80:951-961) Catheter ablation of the atrioventricular (AV) junction with direct-current electrical energy has been performed in animalsl2

show abstract

Section: Ablation Protocolmentioning

confidence: 99%

Chronic incomplete atrioventricular block induced by radiofrequency catheter ablation.

et al. 1989

Self Cite

View full text Add to dashboard Cite

show abstract

Atrial Fibrillation and Atrial Flutter

Hornero

2006

Wiley Encyclopedia of Biomedical Engineering

View full text Add to dashboard Cite

Nonpharmacologic treatments of atrial fibrillation and atrial flutter potentially offer therapy, sparing patients the long‐term risks of antiarrhythmic drug therapy. For patients with typical atrial flutter, contemporary catheter ablation techniques afford cure rates in excess of 85%. For patients with atrial fibrillation, surgical Maze procedure and catheter‐based procedures emulating aspects of the surgical Maze technique can today offer cure rates around 75%. However, additional research and technological development is necessary to further define and refine the best effective procedure. For the present, because each therapeutic alternative carries its own unique set of risks, side effects, and benefits, patients selection remains of critical importance.

show abstract

Catheter‐directed neodymium:YAG laser injury of the left ventricle for arrhythmia ablation: Dosimetry and hemodynamic, hematologic, and electrophysiologic effects

1989

View full text Add to dashboard Cite

The study evaluated catheter-directed laser injury of the left ventricular myocardium in a canine model as a potential method for treatment of resistant ventricular tachycardia. The relationship between laser energy delivered, the laser delivery characteristics, and the lesion size was evaluated both in vitro and in vivo. The effect of laser injury on several hematologic and hemodynamic parameters was studied. Programmed electrical stimulation studies were performed to assess the proarrhythmia potential of laser injury of the myocardium. The results showed the depth and diameter of myocardial injury to be directly related to total laser energy applied. Both depth and diameter of injury were increased by multiple applications of laser energy to the same myocardial location. One-half to full thickness left ventricular injury was produced without perforation or embolization. Endocardial vaporization occurred only with laser powers higher than necessary to produce full-thickness injury. There was no sustained effect on the hemodynamic or hematologic variables studied, nor were proarrhythmia effects identified. The laser injury produced in these studies was of smaller magnitude than might be necessary for clinical arrhythmia ablation, and the lack of sustained hemodynamic effects and pro-arrhythmia potential needs to be verified in subsequent studies with larger laser lesions. The results support continued evaluation of catheter-directed laser injury of the myocardium as a potential method for elimination of life-threatening ventricular arrhythmias.

show abstract

Low-energy transvenous ablation of the canine atrioventricular conduction system with a suction electrode catheter.

Cited by 23 publications

References 23 publications

Chronic incomplete atrioventricular block induced by radiofrequency catheter ablation.

Chronic incomplete atrioventricular block induced by radiofrequency catheter ablation.

Atrial Fibrillation and Atrial Flutter

Catheter‐directed neodymium:YAG laser injury of the left ventricle for arrhythmia ablation: Dosimetry and hemodynamic, hematologic, and electrophysiologic effects

Contact Info

Product

Resources

About