Maastricht University, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands.
Vrije University Brussel, Cardiothoracic Department, Brussels, Belgium.
Pacing Clin Electrophysiol. 2021 Sep;44(9):1585-1592. doi: 10.1111/pace.14320. Epub 2021 Aug 2.
To test in vivo a new design prototype for radio frequency (RF) ablation.
A prototype based on a concept of endo-epicardial biparietal bipolar RF ablation with the atrial tissue interposed and consisting of two specular endocardial-epicardial catheters was tested in four pigs (80±5 kg). The endocardial catheter was introduced into the left atrium through the left atrial appendage on the beating heart. The epicardial counterpart was placed manually on the atrial epicardial surface. The coupling of the two catheters was achieved using a neodymium magnet around the gold plate electrode, and RF was applied to the interposed tissue. The hearts were excised, and the lesions were examined using morphometric evaluation.
The RF application resulted in transmural lesions in all of the four animals tested. In these animals the maximum endocardial width (W ) was 6.34 ± 0.25, 6.54 ± 0.33, 6.36 ± 0.57, and 6.49 ± 0.96 mm. The pericardial width (W ) was similar: 6.37 ± 0.47, 6.58 ± 0.32, 6.35 ± 0.56 and 6.53 ± 0.94 mm. The lesion area was 924.78, 949.25, 944.25, and 926.05 mm , and the lesion volume was 92.47, 94.92, 94.42, and 92.60 mm , respectively.
The idea of an endocardial-epicardial bidirectional biparietal bipolar radiofrequency tool such that the atrial tissue is fully interposed between the two RF poles might be promising for future clinical applications. Further research is warranted.
在体内测试一种新的射频 (RF) 消融设计原型。
基于心内膜-心外膜双极双向 RF 消融的概念,采用插入心房组织的双镜像心内膜-心外膜导管设计,对 4 头猪(80±5kg)进行了测试。心内膜导管经左心耳在心搏的心脏中引入左心房。心外膜对应物手动放置在心外膜表面。通过金板电极周围的钕磁铁实现两个导管的耦合,并将 RF 施加到插入的组织。切除心脏,并使用形态计量评估检查病变。
在所有 4 只测试动物中,RF 应用导致了贯穿壁的病变。在这些动物中,最大的心内膜宽度 (W) 为 6.34±0.25、6.54±0.33、6.36±0.57 和 6.49±0.96mm。心包宽度 (W) 相似:6.37±0.47、6.58±0.32、6.35±0.56 和 6.53±0.94mm。病变面积分别为 924.78、949.25、944.25 和 926.05mm,病变体积分别为 92.47、94.92、94.42 和 92.60mm。
心内膜-心外膜双向双极 RF 工具的理念,即心房组织完全插入两个 RF 极之间,可能对未来的临床应用有希望。需要进一步研究。