Document Detail


Development of an ovine model of pediatric complete heart block.
MedLine Citation:
PMID:  21227467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Complete heart block is a significant clinical problem that can limit the quality of life in affected children. To understand the pathophysiology of this condition and provide for development of novel therapies, we sought to establish a large animal model of permanent, pacemaker-dependent atrioventricular block (AVB) that mimics the size and growth characteristics of pediatric patients.
MATERIALS AND METHODS: We utilized nine immature lambs weighing 10.5 ± 1.4 kg. After implantation of dual-chamber pacemaker devices with fixed leads, AVB was produced by interrupting His-bundle conduction using radio-frequency ablation at the base of the non-coronary cusp of the aortic valve. Ablations (30 to 60 s in duration) were performed under fluoroscopic guidance with electrophysiological monitoring. Interrogation of pacemakers and electrocardiography (ECG) determined the persistence of heart block. Ovine hearts were also examined immunohistochemically for localization of conduction tissue.
RESULTS: AVB was produced in eight animals using an atypical approach from the left side of the heart. One animal died due to ventricular fibrillation during ablation proximal to the tricuspid annulus and one lamb was sacrificed postoperatively due to stroke. Four sheep were kept for long-term follow-up (109.8 ± 32.9 d) and required continuous ventricular pacing attributable to lasting AVB, despite significant increases in body weight and size.
CONCLUSIONS: We have created a large animal model of pediatric complete heart block that is stable and technically practicable. We anticipate that this lamb model will allow for advancement of cell-based and other innovative treatments to repair complete heart block in children.
Authors:
Bjoern Sill; Nathalie Roy; Peter E Hammer; John K Triedman; Daniel C Sigg; Mark F Kelly; Arthur Nedder; Patricia S Dunning; Douglas B Cowan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-12-05
Journal Detail:
Title:  The Journal of surgical research     Volume:  166     ISSN:  1095-8673     ISO Abbreviation:  J. Surg. Res.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-11     Completed Date:  2011-05-24     Revised Date:  2013-07-02    
Medline Journal Info:
Nlm Unique ID:  0376340     Medline TA:  J Surg Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e103-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Aortic Valve
Atrioventricular Node / pathology,  physiopathology
Body Size
Bundle of His / pathology,  physiopathology
Catheter Ablation
Disease Models, Animal*
Electrocardiography
Female
Heart Block / pathology,  physiopathology*,  therapy*
Pacemaker, Artificial*
Pediatrics
Prosthesis Implantation / methods
Sheep*
Grant Support
ID/Acronym/Agency:
HL068915/HL/NHLBI NIH HHS; HL088206/HL/NHLBI NIH HHS; R01 HL068915-07/HL/NHLBI NIH HHS; R01 HL088206-04/HL/NHLBI NIH HHS
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