Termination of Atrial Fibrillation With Epicardial Cooling in the Oblique Sinus
| Autor: | Greg Seifert, Chance M. Witt, Doug Beinborn, Rich Sanders, Niyada Naksuk, Deepak Padmanabhan, Steve Berhow, Sean Dalton, Ammar M. Killu, Samuel J. Asirvatham, Samuel O’Neil, Trevor A. Mccaw, Allan Witz, Arjun D. Sharma, Christopher G. Scott, Paul A. Friedman, Charles Ritrivi |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Defibrillation medicine.medical_treatment Electric Countershock 030204 cardiovascular system & hematology 03 medical and health sciences Dogs 0302 clinical medicine Interquartile range Internal medicine Atrial Fibrillation Metal device medicine Animals 030212 general & internal medicine Sinus (anatomy) Atrial pacing Human studies business.industry Atrial fibrillation medicine.disease Defibrillators Implantable Disease Models Animal medicine.anatomical_structure Cryotherapy Cardiology business Pericardium Atrial Remodeling |
| Zdroj: | JACC: Clinical Electrophysiology. 4:1362-1368 |
| ISSN: | 2405-500X |
| DOI: | 10.1016/j.jacep.2018.06.016 |
| Popis: | This study aimed to determine if epicardial cooling could repeatedly terminate induced atrial fibrillation (AF) in a canine heart.Rapid termination of AF could control symptoms and prevent atrial remodeling; however, defibrillation by internal electrical cardioversion is not tolerable to most patients. Cooling of the epicardium slows atrial conduction and may provide a less painful method to quickly terminate AF.AF was induced with atrial myocardial epinephrine injections and rapid atrial pacing in an open-chest canine. Attempts at termination were performed with a small metal device that was either cooled to 5°C or kept at body temperature (control module). The device was placed on the epicardial surface in the oblique sinus. The time from device contact to termination of AF was recorded.In 5 different canine studies, there were 57 attempts at AF termination with either a 5°C module (34 attempts) or a control module (23 attempts). The median (interquartile range [IQR]) time to AF termination was 24 s (IQR: 15 to 35 s) for the 5°C therapy and 100 s (IQR: 47 to 240 s) for the body temperature treatments (p 0.001). In the control group, there were 8 AF episodes that continued up to 4 min. Subsequent application of the 5°C cooling module terminated AF in all cases.Epicardial cooling in the oblique sinus is effective for repeated termination of AF in a canine heart. If reproduced in human studies, epicardial cooling with an implantable device may provide a method for management of patients with AF. |
| Databáze: | OpenAIRE |
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