DeSimone Christopher V, Madhavan Malini, Venkatachalam Kalpathi L, Knudson Mark B, Asirvatham Samuel J
Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Cardiovasc Revasc Med. 2013 May-Jun;14(3):144-8. doi: 10.1016/j.carrev.2013.03.004. Epub 2013 Apr 29.
Ablation and anti-arrhythmic medications have shown promise but have been met with varying success and unwanted side effects such as myocardial injury, arrhythmias, and morbidity from invasive surgical intervention. The answer to improving efficacy of ablation may include modulation of the cardiac aspect of the autonomic nervous system. Our lab has developed a novel approach and device to navigate the oblique sinus and to use DC current and saline/alcohol irrigation to selectively stimulate and block the autonomic ganglia found on the epicardial side of the heart. This novel approach minimizes myocardial damage from thermal injury and provides a less invasive and targeted approach. For feasibility, proof-of-concept, and safety monitoring, we carried out canine studies to test this novel application. Our results suggest a safer and less invasive way of modulating arrhythmogenic substrate that may lead to improved treatment of AF in humans.
消融术和抗心律失常药物已显示出前景，但取得的成功各异，还存在诸如心肌损伤、心律失常以及侵入性外科手术干预带来的发病率等不良副作用。提高消融术疗效的答案可能包括调节自主神经系统的心脏方面。我们实验室已开发出一种新颖的方法和设备，用于导航斜窦，并利用直流电以及盐水/酒精灌注来选择性地刺激和阻断位于心脏心外膜侧的自主神经节。这种新颖的方法将热损伤导致的心肌损伤降至最低，并提供了一种侵入性较小且有针对性的方法。为了验证可行性、概念验证和安全性监测，我们进行了犬类研究以测试这种新颖的应用。我们的结果表明，有一种更安全、侵入性更小的方式来调节致心律失常基质，这可能会改善人类房颤的治疗。
