Cryoablation time-dependent dose-response effect at minimal temperatures (-80°C): an experimental study

被引:17
作者
Atienza, Felipe [1 ]
Almendral, Jesus [1 ]
Sanchez-Quintana, Damian [2 ]
Zaballos, Matilde [3 ]
Murillo, Margarita [2 ]
Jimeno, Concepcion [3 ]
Parra, Veronica [3 ,4 ]
Fernandez-Aviles, Francisco [1 ]
机构
[1] Univ Gregorio Maranon, Gen Hosp, Dept Cardiol, Madrid 28007, Spain
[2] Fac Med Badajoz, Dept Human Anat & Cell Biol, Badajoz, Spain
[3] Univ Gregorio Maranon, Gen Hosp, Dept Anesthesiol, Madrid 28007, Spain
[4] Univ Gregorio Maranon, Gen Hosp, Dept Pathol, Madrid 28007, Spain
来源
EUROPACE | 2009年 / 11卷 / 11期
关键词
Cryothermal ablation; Atrioventricular block; Perinodal ablation; Atrioventricular node; Supraventricular tachycardias; NODAL REENTRANT TACHYCARDIA; CATHETER CRYOABLATION; RADIOFREQUENCY ABLATION; ACCESSORY PATHWAYS; ATRIOVENTRICULAR-CONDUCTION; SAFETY; EFFICACY; CHILDREN; BLOCK;
D O I
10.1093/europace/eup310
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To establish a temporal safety window for cryoablation at minimal temperatures and to assess the electrophysiological and histological changes as a function of the application duration. Twenty mini-pigs underwent AV nodal cryoablation at -80 degrees C without prior cryomapping. The duration of the cryoapplication following atrioventricular block (AVB) was randomized to 0, 10, 20, 40, or 60 s. Atrioventricular block was obtained in all animals after a median of 3 (1-8 interquartile range) applications. One week later, AV nodal conduction fully recovered in animals with application duration < 10 s, whereas persistent AVB incidence increased as a function of time in animals with longer applications duration. Cryoablation application duration following AVB was the only independent predictor of persistent AVB (OR, 1.116; 95% CI, 1.013-1.229; P = 0.026). There was no difference in lesion location or size between animals with vs. those without persistent AVB at 1 week. However, animals randomized to longer application duration demonstrated higher degree of cell destruction and fibrotic content. In this closed-chest pig model, there was a relation between cryoapplication duration following AVB at -80 degrees C and recovery of conduction. A safety window of at least 10 s was observed in all cases.
引用
收藏
页码:1538 / 1545
页数:8
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