Prevention of Coagulum Formation With Simultaneous Charge Delivery in Radiofrequency Ablation: A Canine Model.

JACC. Clinical Electrophysiology
Bernard LimSamuel J Asirvatham

Abstract

This study reports on a novel method to prevent coagulum formation by continuously delivering a negative charge to the catheter tip to repel negatively charged fibrinogen molecules during RF ablation. Radiofrequency (RF) ablation for cardiac arrhythmias is associated with a 70% incidence of coagulum formation on the catheter tip during ablation and a 10% incidence of thromboembolic events. Catheter tip thrombus can impede RF energy to the tissue, reducing efficacy and increasing procedure times. A novel circuit was built to deliver a negative, fixed-offset, direct current-based charge using a 9-V battery, placed in parallel with an RF delivery unit during RF ablation. In in vivo canine experiments, standard ablation catheters were advanced into atria and ventricles under fluoroscopic guidance. The presence of thrombus with and without RF delivery was identified with intracardiac echocardiography. Scanning electron microscopy of the catheter tips showed clot coverage of the catheter tip to be 90% for noncharged catheters compared to 0% (p < 0.01) in negatively charged catheters. Volume of clot formed on the catheter tip decreased with increased amount of charge (140 ± 5.3 arbitrary units with no charge vs. 0 arbitrary units with...Continue Reading

References

Sep 1, 1989·Pacing and Clinical Electrophysiology : PACE·M E RingA R Graham
Jan 1, 1986·Clinical Cardiology·C B-LundqvistE Varnauskas
Mar 15, 1996·The American Journal of Cardiology·M R EpsteinJ P Saul
Aug 6, 2000·Stroke; a Journal of Cerebral Circulation·A BarthR W Seiler
Jul 27, 2001·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·D S LeeD M Newman
Oct 3, 2002·Pacing and Clinical Electrophysiology : PACE·Julie M DemolinFred H M Wittkampf
Oct 1, 1953·The American Journal of Physiology·P N SAWYER, J W PATE
Oct 1, 1953·The American Journal of Physiology·P N SAWYERC S WELDON
Oct 16, 2003·Journal of the American Chemical Society·Seung-Yong JungPaul S Cremer
Apr 9, 2005·Journal of Cardiovascular Electrophysiology·Fred H M WittkampfWarren M Jackman
Apr 20, 2005·Advances in Protein Chemistry·John W Weisel
Jun 11, 2005·Journal of Cardiovascular Electrophysiology·Kataneh MalekiJonathan S Steinberg
Jan 24, 2006·Journal of Cardiovascular Electrophysiology·Samuel J Asirvatham, Paul A Friedman
Nov 15, 2006·Pacing and Clinical Electrophysiology : PACE·Fred H M Wittkampf, Hiroshi Nakagawa
Mar 28, 2008·Journal of Cardiovascular Electrophysiology·Bernard LimSamuel J Asirvatham
Jul 6, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Thomas DenekeMartin Bansmann
May 21, 2013·Journal of the American College of Cardiology·Caroline MediJonathan Kalman

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Citations

Aug 3, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Alan SugrueSamuel J Asirvatham
Oct 30, 2018·Journal of the American Heart Association·Christopher LiviaChristopher J McLeod

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