Document Detail

Surgical ablation for atrial fibrillation: the efficacy of a novel bipolar pen device in the cardioplegically arrested and beating heart.
MedLine Citation:
PMID:  19026819     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The introduction of ablation technology has simplified surgical intervention for atrial fibrillation. However, most ablation devices cannot create focal transmural lesions on the beating heart and have difficulty ablating specific regions of the atria, such as the atrioventricular isthmus, coronary sinus, and ganglionated plexus. The purpose of this study was to examine the efficacy of a pen-type bipolar radiofrequency ablation device on both arrested and beating hearts.
METHODS: Endocardial and epicardial atrial tissues in the free wall, left atrial roof, atrioventricular annuli, and coronary sinus were ablated for varying time intervals (2.5-15 seconds) in porcine cardioplegically arrested (n = 6) and beating (n = 9) hearts. The hearts were stained with 1% 2,3,5-triphenyl-tetrazolium chloride solution and sectioned to determine lesion depth and width. In 5 animals epicardial fat pads containing ganglionated plexus were stimulated and ablated.
RESULTS: Lesion depth increased with ablation time similarly in both arrested and beating hearts. Transmurality was fully achieved in the thin atrial tissue (<4 mm) at 10 seconds in the beating and arrested hearts. The device had a maximal penetration depth of 6.1 mm. Epicardial ablation of the coronary sinus showed complete penetration through the left posterior atrium only in the arrested heart. Seven of 17 fat pads demonstrated a vagal response. All vagal responses were eliminated after ablation.
CONCLUSION: The bipolar pen effectively ablated atrial tissue in both arrested and beating hearts. This device might allow the surgeon to ablate tissue in regions not accessible to other devices during atrial fibrillation surgery.
Shun-ichiro Sakamoto; Rochus K Voeller; Spencer J Melby; Shelly C Lall; Nai-lun Chang; Richard B Schuessler; Ralph J Damiano
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  136     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-25     Completed Date:  2008-12-16     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1295-301     Citation Subset:  AIM; IM    
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MeSH Terms
Atrial Fibrillation / surgery*
Catheter Ablation / instrumentation*
Heart Arrest, Induced*
Heart Atria / pathology
Mitral Valve / pathology
Myocardium / pathology
Pericardium / pathology
Tetrazolium Salts / diagnostic use
Tricuspid Valve / pathology
Grant Support
F32 HL082129-02/HL/NHLBI NIH HHS; R0-1HL032257-21/HL/NHLBI NIH HHS; R01 HL032257/HL/NHLBI NIH HHS; R01 HL032257-25A2/HL/NHLBI NIH HHS; T32 HL007776/HL/NHLBI NIH HHS; T32 HL007776-15/HL/NHLBI NIH HHS
Reg. No./Substance:
0/Tetrazolium Salts; 298-95-3/neotetrazolium

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

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