Williams Mathew R, Knaut Michael, Bérubé Dany, Oz Mehmet C
Columbia University, New York Presbyterian Hospital, New York, New York, USA.
Ann Thorac Surg. 2002 Nov;74(5):1500-5. doi: 10.1016/s0003-4975(02)03951-6.
Recently, there has been renewed interest in simplifying a surgical cure for atrial fibrillation. Microwave energy ablation provides an easier and faster surgical technique, in lieu of traditional "cut and sew," which can also be applied on the beating heart.
Specific absorption rate (SAR) and thermal profiles were determined after microwave energy ablation intended for clinical application. Lesion geometry measures obtained in vitro with tissue equivalent media were compared with values collected from animal myocardium.
Thermal profile analysis demonstrated lesion penetration depths of 2.5, 3, and 5 mm after 8, 16, and 24 seconds, respectively, with microwave power application of 40 W. Dosimetric studies performed using animal myocardium corresponded to the thermal profile analysis and showed that lesion depth was controlled by the output power and the ablation time.
Lesion geometry in tissue using microwave energy is similar to that predicted from in vitro analysis. The ablation depths and thermal profile of microwave ablation is favorable for performing atrial ablation, and this is corroborated by favorable early clinical results.
最近,人们对简化心房颤动的手术治疗方法重新产生了兴趣。微波能量消融提供了一种比传统“切割缝合”更简便、快速的手术技术,且该技术也可应用于跳动的心脏。
在进行旨在临床应用的微波能量消融后,测定比吸收率(SAR)和热分布图。将在体外使用组织等效介质获得的损伤几何测量值与从动物心肌收集的值进行比较。
热分布图分析表明,在施加40W微波功率的情况下,分别在8、16和24秒后损伤穿透深度为2.5、3和5mm。使用动物心肌进行的剂量学研究与热分布图分析结果相符,表明损伤深度由输出功率和消融时间控制。
使用微波能量在组织中形成的损伤几何形状与体外分析预测的相似。微波消融的消融深度和热分布图有利于进行心房消融,早期良好的临床结果也证实了这一点。