Liu Changcheng, Wang Liangshan, Li Bo, Wang Jin, Hu Yucai, Li Songnan, Yu Yang, Gu Chengxiong
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China; Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China; Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
J Surg Res. 2018 Aug;228:211-220. doi: 10.1016/j.jss.2018.02.031. Epub 2018 Apr 11.
Left ventricular aneurysm (LVA) might be an arrhythmogenic substrate. Endocardiectomy and cryoablation for ventricular tachycardia (VT) with LVA can cause extensive myocardial damage. We aimed to evaluate the feasibility of surgical radial linear ablation for VT with LVA guided by electrophysiological mapping.
Porcine models of VT with LVA were developed. Endocardial and epicardial substrate mapping during sinus rhythm were performed under thoracotomy. Surgical radial linear ablation was achieved by a bipolar radiofrequency ablation device. Outcomes, including procedural success and acute freedom of VT, were analyzed.
Fifteen of 20 pigs developed LVA in a 6-wk survival period. A total of 28 sustained monomorphic VTs were initiated in 13 of 15 pigs (86.67%). The number of potential points captured from the endocardium and epicardium were 319 ± 45 and 358 ± 52 per animal, respectively. The ablative targets containing abnormal potentials were located largely on the border zone of LVA. Eight linear lesions from core to border zone of LVA were achieved per animal in a radial and even manner continuously, and ablation was repeated three times to transect border zone. The acute freedom of VT was 84.62%, P < 0.05.
Surgical linear endo-epicardial ablation seemed to be feasible in a porcine model with VT and LVA.
