Impact of myocardial fiber orientation on lesions created by a novel heated saline-enhanced radiofrequency needle-tip catheter: An MRI lesion validation study.

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Atsushi SuzukiDouglas L Packer

Abstract

Irrigated needle catheter ablation is efficacious for creation of transmural lesions in the left ventricle (LV). However, interdependence of needle orientation and myocardial fiber orientation and the resulting influence on lesion creation remain unclear. The purpose of this study was to investigate the impact of myocardial fiber orientation on reproducibility and controllability of lesion creation in LV myocardium using a heated saline-enhanced radiofrequency (SERF) needle-tip catheter system. Eleven dogs underwent catheter ablation using this novel catheter. Ablative lesions were created using different power and ablation times (15-50 W; application 25-120 seconds; 60°C irrigation saline at 10 mL/min). Hearts were explanted, and lesions were evaluated using 3-T cardiac magnetic resonance (CMR), gross pathologic, and histologic investigations. Forty-three of 57 lesions (75.4%) were transmural, and lesion depth reached approximately 90% of LV wall thickness. Lesion volume in both gross pathology and ex vivo CMR showed a positive linear correlation with power × radiofrequency (RF) time index (r = 0.637, P <.001; and r = 0.786, P <.001, respectively). Maximum width (circumferential direction of LV) and maximum length (long-axis d...Continue Reading

References

Jul 14, 2006·Journal of Cardiovascular Electrophysiology·John L SappWilliam G Stevenson
Jan 9, 2008·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Frédéric SacherWilliam G Stevenson
Oct 11, 2011·Circulation. Arrhythmia and Electrophysiology·Michifumi TokudaUsha B Tedrow
Jun 1, 2012·Annals of Biomedical Engineering·J D BayerN A Trayanova
Aug 7, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Jacob S KoruthVivek Y Reddy
Oct 25, 2013·Journal of Cardiovascular Electrophysiology·Roy M JohnMichael G Curley
Dec 24, 2014·Circulation. Arrhythmia and Electrophysiology·Mitsuru TakamiDouglas L Packer

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Citations

Dec 15, 2020·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Hiroshi NakagawaAyman A Hussein
Jul 22, 2021·Journal of Cardiovascular Electrophysiology·William G StevensonArvindh Kanagasundram

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