Effect of Left Atrial Ablation Process and Strategy on Microemboli Formation During Irrigated Radiofrequency Catheter Ablation in an In Vivo Model

Circulation. Arrhythmia and Electrophysiology
Mitsuru TakamiDouglas L Packer

Abstract

Formation of microemboli during catheter ablation has been suggested as a cause for asymptomatic cerebral emboli. However, it is unknown which part of the process and ablation setting/strategy is most strongly related to this occurrence. A total of 27 pigs were used. Catheter/sheath manipulations in left atrium were performed in 25 of 27 pigs outfitted with microemboli monitoring systems. Ablations using open-irrigated radiofrequency catheters were performed in 18 of 25 pigs. Two of 27 pigs did not undergo left atrial procedures and were injected with microembolic materials in the carotid artery to serve as positive controls. In total, 334 sheath/catheter manipulations (transseptal puncture, sheath flushing, catheter insertion, pulmonary vein venography, and sheath exchange) and 333 radiofrequency applications (power setting, 30/50 W; point-by-point/drag ablations) were analyzed. High microbubble volume in the extracorporeal circulation loop and a high number of microembolic signals in carotid artery were observed during sheath/catheter manipulations especially in saline/contrast injections at fast speed and ablations with steam pop. Fast sheath flushing produced significantly higher microbubble volume than slow sheath flushing...Continue Reading

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Dec 24, 2014·Circulation. Arrhythmia and Electrophysiology·Mitsuru TakamiDouglas L Packer

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Citations

Dec 21, 2016·Scientific Reports·H Immo LehmannDouglas L Packer
Apr 15, 2017·Circulation. Arrhythmia and Electrophysiology·H Immo LehmannDouglas L Packer
Jan 15, 2016·Circulation. Arrhythmia and Electrophysiology·Marco A Mercader
May 1, 2019·Pacing and Clinical Electrophysiology : PACE·Erwin StrökerCarlo de Asmundis
Mar 29, 2019·Arrhythmia & Electrophysiology Review·Shinsuke Miyazaki, Hiroshi Tada
Mar 27, 2018·European Heart Journal·Paulus KirchhofLuigi Di Biase
Mar 27, 2018·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Guy RozenMoussa Mansour
Aug 4, 2018·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·John De HeideS C Yap
Aug 3, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Alan SugrueSamuel J Asirvatham
Nov 21, 2020·Pacing and Clinical Electrophysiology : PACE·Kohki NakamuraShigeto Naito
Sep 26, 2020·JACC. Clinical Electrophysiology·Shinsuke MiyazakiHiroshi Tada
Oct 29, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Marijn H A GroenKars Neven
Jul 22, 2018·JACC. Clinical Electrophysiology·David A IgelDaniel C Sigg
Aug 25, 2018·JACC. Clinical Electrophysiology·Fred H M WittkampfKars Neven
May 1, 2021·Journal of Cardiovascular Electrophysiology·Arvindh KanagasundramWilliam G Stevenson
Dec 21, 2019·JACC. Clinical Electrophysiology·Samuel J Asirvatham, Martin van Zyl

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