心室内膜消融致室间隔损伤：双极与顺序单极消融比较。
Lesion formation by ventricular septal ablation with irrigated electrodes: comparison of bipolar and sequential unipolar ablation.
机构信息
Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610, Japan.
出版信息
Circ J. 2011;75(3):565-70. doi: 10.1253/circj.cj-10-0870. Epub 2010 Dec 24.
BACKGROUND
Ablation of ventricular tachycardia originating from the interventricular septum (IVS) is often limited by the presence of re-entrant pathways deep in the IVS. We compared the efficacy of bipolar ablation vs. sequential unipolar ablation in creating a transmural lesion across the porcine IVS.
METHODS AND RESULTS
Seventeen excised swine hearts were superfused by pulsatile saline flow. Bipolar ablation (at 30 W, 50 W or 70 W for 120 s) was performed between 2 saline-irrigated (20 ml/min) 4-mm tip electrodes, 1 on the left and 1 on the right side of the IVS. Sequential unipolar ablation (at 30 W, 50 W or 70 W for 120 s) was performed on the left and right sides of the IVS with an irrigated-tip catheter. Bipolar ablation produced a narrower, deeper lesion than did unipolar ablation. A transmural lesion was created by sequential unipolar ablation in 7.7%, 8.3% and 0% of tissue preparations and by bipolar ablation in 50.0%, 46.7% and 71.4% of tissue preparations at 30 W, 50 W and 70 W.
CONCLUSIONS
Bipolar ablation of the IVS was highly effective for creating a transmural IVS lesion.
背景
起源于室间隔（IVS）的室性心动过速的消融常常受到 IVS 深部折返途径的限制。我们比较了双极消融与顺序单极消融在创建贯穿猪 IVS 的透壁性病变方面的疗效。
方法和结果
17 个离体猪心通过搏动盐水流进行灌流。在 IVS 的左侧和右侧的 2 个盐水灌洗（20 ml/min）的 4mm 尖端电极之间进行双极消融（30W、50W 或 70W 持续 120s）。在 IVS 的左侧和右侧使用灌洗尖端导管进行顺序单极消融（30W、50W 或 70W 持续 120s）。与单极消融相比，双极消融产生的病变更窄、更深。顺序单极消融在 7.7%、8.3%和 0%的组织标本中产生了透壁性病变，而在 30W、50W 和 70W 时，双极消融在 50.0%、46.7%和 71.4%的组织标本中产生了透壁性病变。
结论
IVS 的双极消融对于创建贯穿 IVS 的透壁性病变非常有效。
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