A new strategy for septal ablation with transendocardial ethanol injection using a multifunctional intracardiac echocardiography catheter: a feasibility study in canines

To evaluate the feasibility and safety of a novel multifunctional intracardiac echocardiography catheter for target septal ablation with transendocardial ethanol injection in canines. Percutaneous transluminal septal myocardial ablation has been the primary catheter-based strategy for the treatment of hypertrophic obstructive cardiomyopathy (HOCM). However, inherent limitations of the technique have reduced its therapeutic efficacy. A new catheter (10 F), integrated with a nitinol needle (29 G) and a 6.5-10-MHz, 32-element, side-fire ultrasound imaging transducer, was delivered into the right ventricle in nine canines and the left ventricle in three canines. A 0.3-ml microbubble and 0.5-1.5 ml absolute ethanol were sequentially injected into the interventricular septum. Electrocardiograph recordings were obtained during the whole procedure. Three hours after this operation, the heart was harvested for gross and histological examination. In all canines, the catheter provided the structural support and helped guide proper needle position within the septum. The microbubble further allowed the confirmation of the needle location through focal echo-density enhancement. Different amounts of ethanol infusion produced a dose-related ef...Continue Reading