Lopez-Merino V, Chorro F J, Sanchis J, Garcia-Civera R, Such L, Camañas A, Paya R
Department of Cardiology, University Hospital, Valencia, Spain.
Eur Heart J. 1989 Feb;10(2):113-9. doi: 10.1093/oxfordjournals.eurheartj.a059450.
The utility of high-frequency current applied through the distal electrode of a conventional electrode-catheter for altering atrio-ventricular conduction was studied in 18 anaesthetized dogs. Following adequate unipolar His bundle recording, current was applied over periods of 20-30 s, with an output power of 30 W. Complete AV block was achieved in all dogs (four dogs on the third attempt, five on the second, and nine on the first). Ten of the dogs were killed after four hours of continuous ECG monitoring (Group I); examination revealed circumscribed spheroidal myocardial lesions at the base of the right atrium over the posterior tricuspid valve; no thrombus formation was encountered. The remaining eight dogs (Group II) were kept alive for three months during which complete block persisted in all cases. The histologic study showed partial replacement of AV nodal and His bundle tissues and myocardium by fibrous tissue. In conclusion, electro-catheter ablation using high-frequency energy is effective for producing complete AV block. The resulting lesions are circumscribed. This method may prove to be an alternative to the transcatheter DC shock for ablation of the AV conduction system.
在18只麻醉犬中研究了通过传统电极导管的远端电极施加高频电流改变房室传导的效用。在进行充分的单极希氏束记录后，以30W的输出功率施加电流20 - 30秒。所有犬均实现了完全性房室传导阻滞（4只犬在第三次尝试时实现，5只在第二次，9只在第一次）。10只犬在连续心电图监测4小时后处死（第一组）；检查发现右心房底部三尖瓣后叶上方有局限性球形心肌病变；未发现血栓形成。其余8只犬（第二组）存活3个月，在此期间所有病例均持续存在完全性传导阻滞。组织学研究显示房室结、希氏束组织和心肌部分被纤维组织替代。总之，使用高频能量的电导管消融术对于产生完全性房室传导阻滞是有效的。所产生的病变是局限性的。这种方法可能被证明是用于消融房室传导系统的经导管直流电击的一种替代方法。
