Document Detail

Thoracoscopic radiofrequency ablation of the myocardium.
MedLine Citation:
PMID:  9558687     Owner:  NLM     Status:  MEDLINE    
Radiofrequency (RF) catheter ablation has been used for the treatment of ventricular tachycardia (VT), however, in some patients VT might result from subepicardial macroreentry that could be successfully terminated by epicardial approach. This study examined the feasibility of thoracoscopic RF ablation of myocardium from epicardium using a custom made electrode. In five mongrel dogs, the thoracoscope was introduced through the 7th intercostal space. A 500-KHz continuous wave RF energy was connected to a custom made multiple electrode probe. Under thoracoscopic guidance, the heart was exposed and the RF probe was introduced. RF ablation was performed on the nonvascular ventricular wall of the beating heart. The left ventricular free wall and right ventricular outflow tract were satisfactorily visualized and ablated. The total dose of RF energy ranged from 50 to 500 J, and the estimated volume of ablated lesions ranged from 41.0-799 mm3. There were significant correlations between the RF discharge output and the irradiated lesion volume (P < 0.01), and the depth of the lesions (P < 0.01). Grossly, after RF ablation the ventricular myocardium demonstrated a circular, well-demarcated area of thermal injury. Volume and depth of the lesion depended upon the total dose of delivered RF energy. Thoracoscopic RF ablation appears to be a minimally invasive and useful method for creating irradiated myocardial lesions from epicardial surface. This method could be technically feasible for the treatment of Vts for which endocardial RF ablation is ineffective.
G Watanabe; T Misaki; K Nakajima; T Ueda; A Yamashita
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  21     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1998 Mar 
Date Detail:
Created Date:  1998-06-04     Completed Date:  1998-06-04     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  553-8     Citation Subset:  IM    
Department of Surgery, Toyama Medical and Pharmaceutical University, Japan.
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MeSH Terms
Catheter Ablation / instrumentation,  methods*
Equipment Design
Feasibility Studies
Myocardium* / pathology
Tachycardia, Ventricular / pathology,  surgery*
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