Document Detail


Microwave ablation for atrial fibrillation: dose-response curves in the cardioplegia-arrested and beating heart.
MedLine Citation:
PMID:  16368338     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Microwave ablation has been used to replace the traditional incisions used in the surgical treatment of atrial fibrillation. However, dose-response curves have not been established in surgically relevant models. The purpose of this study was to develop dose-response curves for the Flex 10 (Guidant, Inc) microwave device in both the acute cardioplegia-arrested heart and on the beating heart. METHODS: Twelve domestic pigs (40 to 45 kg) were subjected to microwave ablation in either the arrested (n = 6) or beating heart (n = 6). The cardioplegia-arrested heart was maintained at 10 degrees to 15 degrees C while six atrial endocardial and seven right ventricular epicardial lesions were created in each animal. On the beating heart, six right atrial and seven ventricular epicardial lesions were created. Ablations were performed for 15, 30, 45, 60, 90, 120, and 150 seconds (65 W, 2.45 GHz). The tissue was stained with 2,3,5-triphenyl-tetrazolium chloride, and sectioned at 5-mm intervals. Lesion depth and width were determined from digital micrographs. RESULTS: Mean atrial wall thickness was 2.8 mm (range, 1 to 8 mm). In the arrested heart, 94% of atrial lesions were transmural at 45 seconds and 100% were transmural at 90 seconds. In the beating heart, only 20% of atrial lesions were transmural despite prolonged ablation times (90 seconds). Ventricular lesion width and depth increased with duration of application, and were similar on the arrested and beating hearts. CONCLUSIONS: Microwave ablation produces linear dose-response curves. Transmural lesions can be reliably produced on the arrested heart, but not consistently on the beating heart.
Authors:
Sydney L Gaynor; Gregory D Byrd; Michael D Diodato; Yosuke Ishii; Anson M Lee; Sandip M Prasad; Jegan Gopal; Richard B Schuessler; Ralph J Damiano
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  81     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-21     Completed Date:  2006-08-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  72-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Animals
Atrial Fibrillation / surgery*
Disease Models, Animal
Dose-Response Relationship, Radiation
Electrocoagulation / instrumentation,  methods*
Endocardium / pathology,  surgery
Heart Arrest, Induced
Heart Atria / pathology,  surgery
Heart Ventricles / pathology,  surgery
Microwaves / therapeutic use*
Myocardial Contraction
Pericardium / pathology,  surgery
Sus scrofa
Time Factors
Comments/Corrections
Comment In:
Ann Thorac Surg. 2006 Jan;81(1):76-7   [PMID:  16368339 ]

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


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