Document Detail

Anatomical pitfalls during encircling cryoablation of the left atrium for atrial fibrillation therapy in the pig.
MedLine Citation:
PMID:  18324459     Owner:  NLM     Status:  MEDLINE    
We previously published encircling endocardial cryo-isolation of the pulmonary vein (PV) region. This study documented mechanisms of isolation failure using CARTO mapping. Cryo-isolation used a modified Surgifrost introduced via a Universal Cardiac Introducer on the left atrial appendage. Of five pigs, two had incomplete isolation and repeat mapping: Activation was over Bachmann's bundle (BB) in one and the coronary sinus (CS) in the other. Repeat cryoablation failed to eliminate gaps. Histologically, the BB gap had nonlesioned sub-epicardial fibres and thick fat covering the cryolesioned BB: fat protecting the epicardium from cryoablation. The inferior gap had a large CS, and a thick myocardium bridging the isthmus: myocardial thickness and CS thermal sink preventing transmural cryolesions. CARTO mapping localized gaps. Although the CS is known to cause failure, its protective mechanism is not well documented. The BB gap is novel. These findings have important clinical implications for isolation of the PV region.
Douglas L Jones; Gerard M Guiraudon; Allan C Skanes; Colette M Guiraudon
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-03-07
Journal Detail:
Title:  Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing     Volume:  21     ISSN:  1383-875X     ISO Abbreviation:  J Interv Card Electrophysiol     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-08     Completed Date:  2008-09-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708966     Medline TA:  J Interv Card Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  187-93     Citation Subset:  IM    
Department of Physiology and Pharmacology, The University of Western Ontario, London, Ontario, Canada, N6A 5C1.
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MeSH Terms
Atrial Fibrillation / surgery*
Catheter Ablation*
Coronary Artery Bypass, Off-Pump / methods
Cryosurgery / methods
Disease Models, Animal
Electrophysiologic Techniques, Cardiac / methods
Heart Atria / anatomy & histology*,  surgery
Pulmonary Veins / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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