Document Detail


Catheter-mediated electrical ablation of the posterior septum via the coronary sinus: electrophysiologic and histologic observations in dogs.
MedLine Citation:
PMID:  4017212     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In a series of 12 dogs, the electrophysiologic and histologic effects of a single damped sine-wave shock delivered via standard electrocatheters to the region of the coronary sinus orifice were investigated. Six dogs received 200 J and six received 360 J of stored energy. The shock was delivered to two consecutive proximal poles of a standard quadripolar catheter positioned at the coronary sinus orifice and connected to the positive output (anode) of a defibrillator. A disc electrode positioned on the anterior chest wall served as the cathode (negative pole). During the shock, voltage and current were recorded. Electrophysiologic testing was done before and 4 weeks after the shock. At 4 weeks, animals were killed and serial sections of the atrioventricular groove and conduction system were performed. No significant long-term change in atrioventricular conduction, spontaneous or induced atrial or ventricular arrhythmias was observed. However, transient atrioventricular block was seen in five and idioventricular rhythms in six animals in the short term. No persistent electrocardiographic changes were observed, and no sudden deaths occurred. Microscopically, transmural injury at the anulus proper or basilar ventricular epicardium was inconstant and infrequent. However, transmural atrial injury at the level of the coronary sinus was produced over a 10 +/- 5 mm length with the 200 J shock and a 21 +/- 6 mm length with the 360 J shock. Neither coronary artery injury nor damage to the conduction system was seen and cardiac tamponade did not occur. However, localized intramural atrial rupture of the coronary sinus wall (on the endocardial aspect only) was observed in each dog, consistent with barotrauma. With the present technique, atrial injury potentially capable of blocking the effects of accessory pathway conduction could be produced without other electrophysiologic alterations or complications. Injury to the anulus proper (and therefore to any accessory pathway per se) is probably unlikely. Barotrauma may play a significant role in the type of injury observed in this study.
Authors:
F Coltorti; G H Bardy; D Reichenbach; H L Greene; R Thomas; D G Breazeale; C Alferness; T D Ivey
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  72     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1985 Sep 
Date Detail:
Created Date:  1985-09-26     Completed Date:  1985-09-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  612-22     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Atrioventricular Node / physiology
Bundle of His / physiology
Dogs
Electricity
Electrocardiography
Electrodes
Electrophysiology
Electroshock
Heart Catheterization / methods*
Heart Septum / physiology*
Pericardium / anatomy & histology

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


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