DOI: 10.1101/469882Nov 14, 2018Paper

Dual cryo-radiofrequency ablation enhances lesion depth in beating human left ventricular preparations

BioRxiv : the Preprint Server for Biology
Matthew SulkinIgor R Efimov

Abstract

Thermally-mediated ablation has utilized various energy sources, including cryothermal, radiofrequency (RF), microwave, laser, and high-frequency ultrasound with the goal of creating lesions to terminate focal sources or block reentrant wavefronts. RF- and cryo-ablation (CR) cause cell death through different mechanisms, and leave behind tissue with altered thermal-electric properties. We aimed to assess the effect of sequential RF and CR combinations on lesion size. Left ventricular (LV) wedge preparations (n=17) were dissected from ten donated human hearts and four epicardial ablation protocols were compared: 1) RF-RF (n=7); 2) CR-CR (n=7); 3) RF-CR (n=7); and 4) CR-RF (n=7). Preparations were continuously paced and perfused with oxygenated Tyrode solution. Ablated tissue was perfused for 3 hours, sectioned, and stained with 2,3,5-triphenyltetrazolium chloride to delineate necrosis. The effect of initial thermal-electric tissue properties on lesion depth during RF application was determined using a finite element method (FEM). CR-RF generated the deepest lesion (p<0.05) compared to protocols 1-3, while lesion width and area were similar among protocols. No energy combination produced a transmural lesion (n=0 of 28) in LV prep...Continue Reading

Related Concepts

Cell Death
Heart
Necrosis
Oxygen
Resuscitation Procedure
Treatment Protocols
Triphenyltetrazolium chloride
Internal
Left Ventricular Structure
Rhizotomy Procedure

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