Moro C, Aragoncillo P, Jorge P
Arrhythmia Unit, C. Ramon y Cajal, Madrid, Spain.
Eur Heart J. 1989 Sep;10(9):833-7. doi: 10.1093/oxfordjournals.eurheartj.a059578.
64 ablation catheter-induced injuries were studied macroscopically and microscopically to determine the incidence of endocardial thrombus formation. Ablation was performed in 16 mongrel dogs, 7 days before necropsy, 16 endocardial necroses were located in the right atrioventricular (AV) junction, 16 in the non-coronary cusp of the aortic valve or the subaortic valve area, 16 in the right and 16 in the left ventricle. Cathodal discharge at the distal electrode was employed against an external anodal plate for ventricular ablation. Necroses in the right AV junction and in the aortic area where the result of transseptal His bundle ablation. Energies ranged from 100-360 J. Pathologic examination was performed 1 week after ablation. 13 thrombi were observed attached to the endocardial necrosis area, of sizes ranging from 1-25 mm diameter (mean 6.9 mm). Six thrombi were found in the septal valve of the tricuspid valve, two in the aortic valve, two in the subaortic region, and three related to ventricular necroses. We conclude that the incidence of thrombosis is 20% in ablation injuries, the majority, 77%, having a diameter less than or equal to 10 mm. No correlation was found between thrombus formation and delivered energy or catheter polarity.
对64例消融导管所致损伤进行了大体和显微镜检查，以确定心内膜血栓形成的发生率。对16只杂种犬进行消融，尸检前7天进行，16处心内膜坏死位于右房室交界区，16处位于主动脉瓣无冠状动脉瓣叶或主动脉瓣下区域，16处位于右心室，16处位于左心室。采用远端电极阴极放电对抗外部阳极板进行心室消融。右房室交界区和主动脉区域的坏死是经房间隔希氏束消融的结果。能量范围为100 - 360焦耳。消融后1周进行病理检查。观察到13个血栓附着于心内膜坏死区域，直径范围为1 - 25毫米（平均6.9毫米）。6个血栓位于三尖瓣隔瓣，2个位于主动脉瓣，2个位于主动脉瓣下区域，3个与心室坏死有关。我们得出结论，消融损伤中血栓形成的发生率为20%，其中大多数（77%）直径小于或等于10毫米。未发现血栓形成与释放能量或导管极性之间存在相关性。
