Transmembraneous irrigation of multipolar radiofrequency ablation catheters: Induction of linear lesions encircling the pulmonary vein ostium without the risk of coagulum formation?

Journal of Interventional Cardiac Electrophysiology

Volumn 10, Issue 3, 2004, Pages 199-209

  Weiss, Christian ^a,d   Stewart, Mark ^c   Franzen, Olaf ^a   Rostock, Thomas ^a   Becker, Jan ^b   Skarda, Jim R ^c   Meinertz, Thomas ^a   Willems, Stephan ^a  

^a Department of Cardiology ^*  (United States)

^b UNIV OF MINNESOTA HOSP AND CLINIC   (United States)

^c MEDTRONIC INC   (United States)

^d UNIVERSITY MEDICAL CENTER HAMBURG EPPENDORF   (Germany)

Author keywords

Ablation electrodes; Atrial fibrillation; Catheter ablation

Indexed keywords

HEPARIN;

ANESTHESIA; ANIMAL EXPERIMENT; ANIMAL MODEL; ANIMAL TISSUE; ARTICLE; ARTIFICIAL MEMBRANE; BLOOD CLOTTING; CARDIOVASCULAR RISK; CATHETER ABLATION; CONTROLLED STUDY; CORONARY SINUS; ECHOCARDIOGRAPHY; ELECTRODE; ELECTROGRAPHY; FEASIBILITY STUDY; FLOW RATE; FLUOROSCOPY; HEART ATRIUM FIBRILLATION; HEART CATHETER; HISTOPATHOLOGY; IMPEDANCE; INFERIOR CAVA VEIN; INTERMETHOD COMPARISON; ISOLATION PROCEDURE; LAVAGE; MUSCLE; NONHUMAN; PRIORITY JOURNAL; PULMONARY VEIN; SAFETY; SHEEP; STAINING; SURGICAL RISK; THIGH; THROMBOEMBOLISM; TISSUE INJURY; TISSUE PERFUSION; TREATMENT OUTCOME;

ANIMALS; CATHETER ABLATION; DISEASE MODELS, ANIMAL; ECHOCARDIOGRAPHY; ELECTRIC IMPEDANCE; ELECTROCARDIOGRAPHY; ELECTRODES, IMPLANTED; EQUIPMENT DESIGN; HEART CONDUCTION SYSTEM; IRRIGATION; MODELS, CARDIOVASCULAR; MUSCLE, SKELETAL; POSTOPERATIVE COMPLICATIONS; PULMONARY VEINS; RISK FACTORS; SHEEP; THIGH;

EID: 3543110987     PISSN: 1383875X     EISSN: None     Source Type: Journal    
DOI: 10.1023/B:JICE.0000026913.46734.04     Document Type: Article

References (24)

1. Haissaguerre M, Jais P, Shah DC, Takahashi A, Hocini M, Quiniou G, Garrigue S, Le Mouroux A, Le Métayer P, Clémenty J. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998;339:659-666.
2. Chen SA, Hsieh MH, Tai TC, Tsai CF, Prakash VF, Yu WC, Hsu TL, Ding YA, Chang MS. Initiation of atrial fibrillation by ectopic beats originating from the pulmonary veins: Electrophysiological characteristics, pharmacological responses, and effects of radiofrequency ablation. Circulation 1999;100:1879-1886.
3. Haissaguerre M, Jais P, Shah DC, Garrigue S, Takahashi A, Lavergne T, Hocini M, Peng JT, Roudaut R, Clementy J. Electrophysiological end point for catheter ablation of atrial fibrillation initiated from multiple pulmonary venous foci. Circulation 2000;101:1409-1417.
4. Haissaguerre M, Shah DC, Jais P, Hocini M, Yamane T, Deisenhofer I, Chauvin M, Garrigue S, Clementy J. Electrophysiological breakthrough from the left atrium to the pulmonary veins. Circulation 2000;102:2643-2645.
5. Gerstenfeld EP, Guerra P, Sparks PB, Hattori K, Lesh MD. Clinical outcome after radiofrequency catheter ablation of focal atrial fibrillation triggers. J Cardiovasc Electrophys 2001;12:900-908.
6. Kok LC, Mangrum M, Haines DE, Mounsey P. Cerebrovascular complications associated with pulmonary vein ablation. J Cardiovasc Electrophysiol 2002;13:764-768.
7. Weiss C, Antz M, Thuneke F, Meinertz T, Kuck K, Willems S. Radiofrequency catheter ablation using long coiled electrodes: Impact of irrigation on lesion dimensions and incidence of coagulum formation. Pacing Clin Electrophysiol 2001;24:933-938.
8. Saito T, Waki K, Becker AE. Left atrial myocardial extension onto pulmonary veins in humans: Anatomic observations relevant for atrial arrhythmias. J Cardiovas Electrophysiol 2000;11:888-894.
9. Nakagawa H, Yamanashi WS, Pitha JV, Arruda M, Wang X, Ohtomo K, Beckman KJ, McClelland JH, Lazzara R, Jackman WM. Comparison of in vivo tissue temperature profile and lesion geometry for radiofrequency ablation with a saline-irrigated electrode versus temperature control in a canine thigh muscle preparation. Circulation 1995;91:2264-2273.
10. Cooper JM, Epstein LM. Use of intracardiac echocardiography to guide ablation of atrial fibrillation. Circulation 2001;104:3010-3013.
11. Chan RC, Johnson SB, Seward JB, Packer DL. The effect of ablation electrode length and catheter tip to endocardial orientation on radiofrequency lesion sze in the canine right atrium. PACE 2002;25:4-13.
12. Bruce CJ, Packer DL, Belohlavek M, Seward JB. Intracardiac echocardiography: Newest technology. J AM Soc Echocardiog 2000;13:788-795.
13. Jais P, Haissaguerre M, Shah DC, Takahashi A, Hocini M, Lavergne T, Lafitte S, Le Mouroux A, Fischer B, Clementy J. Successful irrigated-tip catheter ablation of atrial flutter resistant to conventional radiofrequency ablation. Circulation 1998;98:835-838.
14. Delacretaz E, Stevenson WG, Winters GL, Mitchell RN, Stewart S, Lynch K, Friedman PL. Ablation of ventricular tachycardia with a saline-cooled radiofrequency catheter: Anatomic and histologic characteristics of the lesions in humans. J Cardiovasc Electrophysiol 1999;10:860-865.
15. Ruffy R, Imran MA, Santel DJ, Wharton M. Radiofreqency delivery through a cooled catheter tip allows the creation of larger endomyocardial lesions in the bovine heart. J Cardiovasc Electrophysiol 1995;6:1089-1096.
16. Skrumeda LL, Mehra R. Comparison of standard and irrigated radiofrequency ablation in the canine ventricle. J Cardiovasc. Electrophysiol 1998;9:1196-1205.
17. Nakagawa H, Wittkampf FH, Yamanashi WS, Pitha JV, Imai S, Campbell B, Arrode M, Lazzara R, Jackman WM. Inverse relationship between electrode size and lesion size during radiofrequency ablation with active electrode cooling. Circulation 1998;98:458-465.
18. Haines DE, Verow AF. Observations on electrode-tissue interface temperature and effect on electrical impedance during radiofrequency ablation of ventricular myocardium. Circulation 1990;82:1034-1038.
19. McRury, Panesa D, Mitchell MA, Haines DE. Nonuniform heating during radiofrequency catheter ablation with long electrodes: Monitoring the edge effect. Circulation 1997;96:4057-4064.
20. Mitchell ME, MacRury ID, Haines DE. Linear atrial ablations in a canine model of chronic atrial fibrillation: Morphological and electrophysiological observation. Circulation 1998;97:1176-1185.
21. Natale A, Pisano E, Shewchik J, Bash D, Fanelli R, Potenza D, Santarelli P, Schweikert R, White R, Saliba W, Kanagaratnam L, Tchou P, Lesh MS. First human experience with pulmonary vein isolation using a through-the-balloon circumferential ultrasound ablation system for recurrent atrial fibrillation. Circulation 2000;102:1879-1882.
22. Pappone C, Rosanio S, Oreto G, Tocchi M, Gugliotta F, Vicedomini G, Salvati A, Dicandia C, Mazzone P, Santinelli V, Guletta S, Chierchia S. Circumferential radiofrequency ablation of pulmonary vein ostia a new anatomic approach for curing atrial fibrillation. Circulation 2000;102:2619-2623.
23. Eick OJ, Gerritse B, Schumacher B. Popping phenomena in temperature-controlled RF ablation: When and why do they occur? Pacing and Clin Electrophysiol 2000;23:253-258.
24. Nakagawa H, Imai S, Arruda M, Schleinkofer D, Freihoff F, Shah N, Beckman KJ, McCelland JH, Gonzalez M, Otomo K, Lazzara R, Jackman WM. Prevention of pericardial tamponade during radiofrequency ablation of accessory pathways using a saline irrigated electrode. Pacing Clin Electrophysiol 1997;20:1123 (Abstract).