Radiofrequency Ablation Using an Open Irrigated Electrode Cooled With Half-Normal Saline
| Autor: | Lijun Zheng, Duy T. Nguyen, Edward P. Gerstenfeld, Joseph L. Schuller, Matthew M. Zipse, Paul T. Jurgens, William H. Sauer, Wendy S. Tzou |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Radiofrequency ablation Heart Ventricles medicine.medical_treatment 030204 cardiovascular system & hematology Biophysical Phenomena law.invention 03 medical and health sciences 0302 clinical medicine law medicine Animals cardiovascular diseases 030212 general & internal medicine Therapeutic Irrigation Electrodes Saline Phrenic Nerve Palsy business.industry Arrhythmias Cardiac Equipment Design Surgery surgical procedures operative Anesthesia Models Animal Electrode Catheter Ablation cardiovascular system Cattle Saline Solution business Endocardium |
| Zdroj: | JACC: Clinical Electrophysiology. 3:1103-1110 |
| ISSN: | 2405-500X |
| DOI: | 10.1016/j.jacep.2017.03.006 |
| Popis: | This study evaluated the use of half-normal saline (HNS) as the radiofrequency ablation (RFA) cooling irrigant.Some instances of ventricular arrhythmia may originate deep within myocardium and can be refractory to standard ablation using open irrigated RFA. Recent data suggest that deeper ablation lesions can be created by decreasing the irrigant ionic concentration delivered through open irrigated RFA than by using normal saline (NS).Bovine myocardium was placed in a circulating saline bath. Two RFA catheters were oriented across from each other, with myocardium in between. Sequential unipolar HNS-irrigated RFA was performed and compared to bipolar ablation by using NS or HNS. Unipolar HNS ablation of the ventricles in a porcine model was performed and compared to ablation using NS.Sequential ex vivo unipolar RFA with HNS produced larger lesions than sequential unipolar RFA with NS and produced lesions of similar size to those created with bipolar RFA using NS. Ex vivo bipolar RFA using HNS created the largest lesions. In vivo unipolar HNS ablation in porcine endocardium created larger lesion volumes, 152.9 ± 29.2 μl, compared to 94.7 ± 33.4 μl for unipolar ablation using NS.By decreasing ionic concentration and charge density in RFA using HNS instead of NS irrigant, larger ablation lesions can be created and are similar in size to lesions created using bipolar ablation. This may be a useful ablation strategy for deep myocardial circuits refractory to standard ablation. Further studies are needed to evaluate this novel RFA strategy. |
| Databáze: | OpenAIRE |
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