Animal studies of epicardial atrial ablation

被引:47
作者
Schuessler, Richard B. [1 ]
Lee, Anson M.
Melby, Spencer J.
Voeller, Rochus K.
Gaynor, Sydney L.
Sakamoto, Shun-Ichiro
Damiano, Ralph J., Jr.
机构
[1] Washington Univ, Sch Med, Div Cardiothorac Surg, St Louis, MO 63110 USA
基金
美国国家卫生研究院;
关键词
Atrial fibrillation; Epicardial ablation; Surgical treatment; Cox maze procedure; BIPOLAR RADIOFREQUENCY ENERGY; BEATING HEART; MICROWAVE ABLATION; SURGICAL ABLATION; FIBRILLATION; EFFICACY; WALL;
D O I
10.1016/j.hrthm.2009.07.028
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The Cox maze procedure is an effective treatment of atrial fibrillation, with a long-term freedom from recurrence greater than 90%. The original procedure was highly invasive and required cardiopulmonary bypass. Modifications of the procedure that eliminate the need for cardiopulmonary bypass have been proposed, including use of alternative energy sources to replace cut-and-sew lesions with lines of ablation made from the epicardium on the beating heart. This has been challenging because atrial wall muscle thickness is extremely variable, and the muscle can be covered with an epicardial layer of fat. Moreover, the circulating intracavitary blood acts as a potential heat sink, making transmural lesions difficult to obtain. In this report, we summarize the use of nine different unidirectional devices (four radiofrequency, two microwave, two lasers, one cryothermic) for creating continuous transmural lines of ablation from the atrial epicardium in a porcine model. We define a unidirectional device as one in which all the energy is applied by a single transducer on a single heart surface. The maximum penetration of any device was 8.3 mm. All devices except one, the AtriCure Isolator pen, failed to penetrate 2 mm in some nontransmural sections. Future development of unidirectional energy sources should be directed at increasing the maximum depth and the consistency of penetration.
引用
收藏
页码:S41 / S45
页数:5
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