Aug 27, 2014

Safety and feasibility of closed chest epicardial catheter ablation using electroporation

Circulation. Arrhythmia and Electrophysiology
Kars G E J NevenFred H M Wittkampf

Abstract

Permanent coronary artery damage is a hazardous complication of epicardial radiofrequency ablation. Irreversible electroporation (IRE) is a promising nonthermal ablation modality able to create deep myocardial lesions. We investigated the effects of epicardial IRE on luminal coronary artery diameter and lesion depth. In 5 pigs (60-75 kg), the pericardium was exposed using surgical subxiphoidal epicardial access. A custom deflectable octopolar 12-mm circular catheter with 2-mm ring electrodes was introduced in the pericardium via a steerable sheath. After coronary angiography (CAG), the proximal, mid, and distal left anterior descending, and circumflex coronary arteries were targeted with a single, cathodal 200 J application. CAG was repeated after IRE and after 3 months follow-up. Using quantitative CAG, the minimal luminal diameter at the lesion site was compared with the average of the diameters just proximal and distal to that lesion. Intimal hyperplasia and lesion size were measured histologically. CAG directly postablation demonstrated short-lasting luminal narrowing with normalization in the targeted area, suggestive of coronary spasm. After 3 months, all CAGs were identical to preablation CAGs: mean reference luminal dia...Continue Reading

  • References21
  • Citations15

References

  • References21
  • Citations15

Citations

Mentioned in this Paper

Arterial System
Diagnostic Radiology Modality
Coronary Artery Disease
Pericardial Sac Structure
Myocardium
Entire Coronary Artery
Cardiomyopathies
Anterior Thoracic Region
Foreskin of Penis
Electroporation

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