Document Detail

Catheter tip force required for mechanical perforation of porcine cardiac chambers.
MedLine Citation:
PMID:  21084361     Owner:  NLM     Status:  In-Data-Review    
Aims Catheter manipulation during ablation procedures can produce injury and tamponade. We evaluated the mechanical forces required to perforate a porcine heart with an ablation catheter. Methods and results A 7 Fr, 3.5 mm irrigated radiofrequency (RF) ablation catheter with a force sensor (FS) within its tip was used to create right atrial (RA) free wall lesions in pigs. The intact heart was removed and the FS-equipped catheter was used to mechanically perforate (without RF delivery) the free walls of both atria and ventricles: directly and through an introducer sheath to prevent catheter shaft buckling. Perforation was also performed through epicardially visible RA lesions and adjacent unablated tissue. Twenty-four RA free wall lesions were created in four pigs. One hundred and forty-four mechanical perforations were performed: 44 RA, 30 left atrial (LA), 37 right ventricular (RV), and 33 left ventricular (LV). The RA and RV perforation force (PF) was lower than through the LA and LV (P < 0.0001). The LV perforation time was shorter when the catheter was gripped through an introducer sheath (0.8 ± 0.5 vs. 3.2 ± 3 s, P < 0.0001). Perforation force through transmural RA lesions was lower than through unablated RA tissue (172.4 ± 79.1 vs. 300.6 ± 116.8 g, P < 0.0002). Conclusion The force threshold for mechanical perforation in the porcine heart is lower for right- compared with left-sided chambers, and also lower through recently created RA RF lesions compared with unablated RA tissue. Left ventricular perforation is achieved more rapidly with the ablation catheter in a sheath despite the same PF because the sheath prevents catheter buckling.
Dipen Shah; Hendrik Lambert; Arne Langenkamp; Yuri Vanenkov; Giovanni Leo; Pascale Gentil-Baron; Beat Walpoth
Publication Detail:
Type:  Journal Article     Date:  2010-11-17
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  13     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  277-83     Citation Subset:  IM    
1Electrophysiology Unit, Cardiology Service, Hôpitaux Universitaires de Genéve, Rue Gabriel Perret Gentil 4, CH 1211 Genéve 14, Switzerland.
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