EFFECTS OF COMBINED RADIOFREQUENCY AND DIRECT-CURRENT ENERGY CATHETER ABLATION ON VENTRICULAR MYOCARDIUM IN PIGS

被引:2
作者
KONGSGAARD, E
FOERSTER, A
AASS, H
MADSEN, S
AMLIE, JP
机构
[1] NATL HOSP NORWAY,DEPT PATHOL,OSLO,NORWAY
[2] NATL HOSP NORWAY,INST SURG RES,OSLO,NORWAY
关键词
CATHETER ABLATION; RADIOFREQUENCY CURRENT; DIRECT CURRENT; MYOCARDIUM;
D O I
10.1093/oxfordjournals.eurheartj.a060944
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
When radiofrequency catheter ablation of ventricular arrhythmias is unsuccessful, an option may be to combine it with direct current energy. We therefore investigated the effects of such a combination. Radiofrequency energy was delivered in a bipolar or unipolar fashion to the left and right ventricles through an ablation catheter with a tip electrode 2 mm long, using a temperature-guided radiofrequency generator. Radiofrequency ablation was followed by a single cathodal direct current shock (66 J) with the ablation catheter positioned similarly in six closed-chest pigs. In a control group (six animals) only direct current ablation was performed, with one or two energy applications (66 J) in each ventricle. Two of six animals in the radiofrequency/direct current group died due to perforation in the follow-up period, 1 and 3.5 h after the direct current ablation, respectively. Gross pathological examination of the hearts revealed transmural lesions in all animals. In the radiofrequency/direct current group four lesions were perforated three of which were located in the left ventricle. There was a significant increase in the number of perforations in the radiofrequency/direct current group compared to the control group, where perforation,vas never observed. Haemorrhagic pericardial fluid was found in five of the six animals in the radiofrequency/direct current group compared to none in the control group. These findings show that myocardial ablation with radiofrequency energy followed by direct current energy in the same session may have a high complication rate.
引用
收藏
页码:514 / 520
页数:7
相关论文
共 31 条
[1]   SOME FACTORS AFFECTING BUBBLE FORMATION WITH CATHETER-MEDIATED DEFIBRILLATOR PULSES [J].
BARDY, GH ;
COLTORTI, F ;
IVEY, TD ;
ALFERNESS, C ;
RACKSON, M ;
HANSEN, K ;
STEWART, R ;
GREENE, HL .
CIRCULATION, 1986, 73 (03) :525-538
[2]   CATHETER ABLATION OF VENTRICULAR-TACHYCARDIA USING DEFIBRILLATOR PULSES - ELECTROPHYSIOLOGICAL FINDINGS AND LONG-TERM RESULTS [J].
BORGGREFE, M ;
BREITHARDT, G ;
PODCZECK, A ;
ROHNER, D ;
BUDDE, T ;
MARTINEZRUBIO, A .
EUROPEAN HEART JOURNAL, 1989, 10 (07) :591-601
[3]   CATHETER ABLATION OF IDIOPATHIC RIGHT VENTRICULAR-TACHYCARDIA [J].
BREITHARDT, G ;
BORGGREFE, M ;
WICHTER, T .
CIRCULATION, 1990, 82 (06) :2273-2276
[4]   DIAGNOSIS AND CURE OF THE WOLFF-PARKINSON-WHITE SYNDROME OR PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIAS DURING A SINGLE ELECTROPHYSIOLOGIC TEST [J].
CALKINS, H ;
SOUSA, J ;
ELATASSI, R ;
ROSENHECK, S ;
DEBUITLEIR, M ;
KOU, WH ;
KADISH, AH ;
LANGBERG, JJ ;
MORADY, F .
NEW ENGLAND JOURNAL OF MEDICINE, 1991, 324 (23) :1612-1618
[5]   RADIOFREQUENCY CATHETER ABLATION FOR TREATMENT OF BUNDLE-BRANCH REENTRANT VENTRICULAR-TACHYCARDIA - RESULTS AND LONG-TERM FOLLOW-UP [J].
COHEN, TJ ;
CHIEN, WW ;
LURIE, KG ;
YOUNG, C ;
GOLDBERG, HR ;
WANG, YS ;
LANGBERG, JJ ;
LESH, MD ;
LEE, MA ;
GRIFFIN, JC ;
SCHEINMAN, MM .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1991, 18 (07) :1767-1773
[6]   HISTOLOGIC-CHANGES AND ARRHYTHMOGENICITY AFTER DISCHARGE THROUGH TRANS-SEPTAL CATHETER ELECTRODE [J].
DAVIS, JC ;
FINKEBEINER, W ;
RUDER, MA ;
DICARLO, L ;
MATSUBARA, T ;
CHU, W ;
WINSTON, SA ;
BHARATI, S ;
SCHEINMAN, MM ;
LEV, M .
CIRCULATION, 1986, 74 (03) :637-644
[7]   RADIOFREQUENCY CATHETER ABLATION OF REFRACTORY VENTRICULAR-TACHYCARDIA [J].
DAVIS, MJE ;
MURDOCK, C .
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1988, 11 (06) :725-729
[8]  
DESAI J, 1989, AM J CARDIOL, V63, P1010
[9]  
EVANS GT, 1989, PACE, V11, P1621
[10]   CLINICAL-EXPERIENCE WITH FULGURATION AND ANTIARRHYTHMIC THERAPY FOR THE TREATMENT OF VENTRICULAR-TACHYCARDIA - LONG-TERM FOLLOW-UP OF 43 PATIENTS [J].
FONTAINE, G ;
TONET, JL ;
FRANK, R ;
ROUGIER, I .
CHEST, 1989, 95 (04) :785-797