Document Detail


Intrapericardial balloon placement for prevention of collateral injury during catheter ablation of the left atrium in a porcine model.
MedLine Citation:
PMID:  19914143     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Catheter ablation of the left atrium (LA) is associated with potential collateral injury to surrounding structures, especially the esophagus and the right phrenic nerve (PN).
OBJECTIVES: The purpose of this study was to evaluate the efficacy and feasibility of intrapericardial balloon placement (IPBP) for the protection of collateral structures adjacent to the LA.
METHODS: Electroanatomic mapping was performed in porcine hearts using a transseptal endocardial approach in eight swine weighing 40-50 kg. An intrapericardial balloon was inflated in the oblique sinus, via percutaneous epicardial access, to displace the esophagus. Similarly, with the balloon positioned in the transverse sinus, IPBP was used to displace the right PN. Esophageal temperature was monitored while endocardial radiofrequency (RF) energy was delivered to the distal inferior PV.
RESULTS: In all cases, balloon placement was successful with no significant effects on hemodynamic function. Balloon inflation increased the distance between the esophagus and posterior LA by 12.3 +/- 4.0 mm. IPBP significantly attenuated increases in luminal esophageal temperature during endocardial RF application (6.1 +/- 2.4 degrees C vs. 1.2 +/- 1.1 degrees C; P<.0001). High-output endocardial pacing from the right superior pulmonary vein ostium stimulated PN activity. After displacement of the right PN with IPBP, PN capture was abolished in 30 (91%) of 33 sites.
CONCLUSIONS: These findings demonstrate that in an animal model, IPBP is feasible in the setting of catheter ablation procedures and has the potential to decrease the risk of collateral damage to the esophagus and PN during LA ablation.
Authors:
Shiro Nakahara; Rafael J Ramirez; Eric Buch; Yoav Michowitz; Marmar Vaseghi; Carlos de Diego; Noel G Boyle; Aman Mahajan; Kalyanam Shivkumar
Related Documents :
25312243 - Epoprostenol (veletri(®), caripul (®)): a review of its use in patients with pulmonar...
454023 - Vascular evaluation for balloon pumping.
9369503 - Venous thrombosis in and after extracorporeal membrane oxygenation: detection and follo...
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-09-17
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  7     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-04     Completed Date:  2011-03-22     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  81-7     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Animals
Catheter Ablation / adverse effects*
Catheterization*
Esophagus / injuries*
Feasibility Studies
Heart Atria / surgery*
Hemodynamics
Pericardium*
Phrenic Nerve / injuries*
Swine
Wounds and Injuries / prevention & control
Grant Support
ID/Acronym/Agency:
HL067647/HL/NHLBI NIH HHS; IH RO1-HL084261/HL/NHLBI NIH HHS; R01 HL084261/HL/NHLBI NIH HHS; R01 HL084261-04/HL/NHLBI NIH HHS
Comments/Corrections

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


Previous Document:  Electrical resynchronization induced by direct His-bundle pacing.
Next Document:  Differences in accessory pathway location by sex and race.