Morgan J M, Roberts P R, Allen S, Gallagher P J, Gibson C, Cunningham A D
Wessex Cardiothoracic Center, Southampton University Hospital, United Kingdom.
J Cardiovasc Electrophysiol. 1999 Apr;10(4):566-73. doi: 10.1111/j.1540-8167.1999.tb00714.x.
Use of a novel ablation catheter for the creation of linear transmural endocardial lesions, which uses a coaxially moving ablation electrode mounted on the terminal portion of a catheter shaft and able to move axially for a distance of up to 4 cm, is reported.
The coaxially moving ablation electrode is moved by a sliding mechanism in the catheter handle. The distal portion of the catheter shaft is steerable. Bipolar or unipolar electrograms can be recorded from electrodes on the catheter tip and the coaxially moving ablation. Radiofrequency (RF) current is delivered to the coaxially moving ablation electrode with thermocouple temperature control. This ablation catheter was evaluated in five (30 to 65 kg) anesthetized pigs and introduced via the venous/arterial systems into the right and left atrium (1 lesion) (using the retrograde aortic approach). The catheter was maneuvered to bring the slide range into apposition with atrial endocardium. The coaxially moving ablation electrode was deployed to the terminal portion of the catheter's slide range and then withdrawn in 2-mm steps. RF current was delivered to the coaxially moving ablation electrode at each point (maximum temperature 70 degrees C). Postmortem examination of eight endocardial linear lesions (2.2 to 4.1 cm length) was made 1 to 3 hours after creation. Histopathologic examination confirmed transmural myocyte necrosis along the length of the lesion, that included the trabeculated right atrium.
We conclude that a catheter using a moveable electrode creates continuous linear transmural lesions and could find clinical application in the therapy of a variety of reentry tachycardia mechanisms.
据报道，一种新型消融导管可用于创建线性透壁心内膜损伤，该导管在导管轴末端安装有同轴移动的消融电极，且能够轴向移动达4厘米的距离。
同轴移动的消融电极由导管手柄中的滑动机制驱动。导管轴的远端可操控。可从导管尖端电极和同轴移动的消融电极记录双极或单极电图。通过热电偶温度控制将射频（RF）电流输送到同轴移动的消融电极。对5只体重30至65千克的麻醉猪进行了该消融导管的评估，并通过静脉/动脉系统将其引入右心房和左心房（1个损伤）（采用逆行主动脉入路）。操控导管使滑动范围与心房内膜贴合。将同轴移动的消融电极展开至导管滑动范围的末端部分，然后以2毫米的步长回撤。在每个点向同轴移动的消融电极输送RF电流（最高温度70摄氏度）。在损伤形成后1至3小时对8个心内膜线性损伤（长度2.2至4.1厘米）进行了尸检。组织病理学检查证实沿损伤长度包括小梁化右心房存在透壁心肌细胞坏死。
我们得出结论，使用可移动电极的导管可创建连续的线性透壁损伤，并可能在多种折返性心动过速机制的治疗中找到临床应用。
