Division of Cardiac Electrophysiology, Virginia Commonwealth University, Richmond, Virginia, USA.
Department of Pathology, Virginia Commonwealth University, Richmond, Virginia, USA.
J Cardiovasc Electrophysiol. 2023 Apr;34(4):900-907. doi: 10.1111/jce.15840. Epub 2023 Feb 7.
Radiofrequency ablation (RFA) utilizing half-normal saline (HNS) irrigation is a promising intervention to circumvent commonly encountered limitations during radiofrequency ablation of deep myocardial substrate. Few studies to date have analyzed the morphologic changes in the human myocardium following HNS RFA.
Three patients with symptomatic ventricular tachycardia (VT) who underwent RFA with HNS irrigation underwent pathological specimen examination at time of autopsy or following native heart explant at the time of cardiac transplantation. Gross evaluation of the heart was performed fresh and after fixation in 10% formalin. A routine examination was performed with fixation in 10% formalin. Sections of lesioned tissue were paraffin embedded and evaluated using standard hematoxylin and eosin (H&E) staining.
Irrigated RF ablation with HNS irrigant produces coagulative necrosis as well as several delayed histopathological changes with a deeper field of effective ablation. Transmurality may not be obtained in the ventricular myocardium with endocardial, epicardial, or sequential unipolar HNS ablation.
利用半生理盐水（HNS）冲洗的射频消融（RFA）是一种有前途的干预措施，可以规避在对深部心肌基质进行射频消融时经常遇到的限制。迄今为止，很少有研究分析过 HNS RFA 后人类心肌的形态变化。
3 名患有症状性室性心动过速（VT）的患者在接受 HNS 冲洗的 RFA 后，在尸检时或在心脏移植时进行了原生心脏移植时进行了病理标本检查。新鲜和 10%福尔马林固定后对心脏进行大体评估。用 10%福尔马林固定进行常规检查。将受损组织的切片石蜡包埋并用标准苏木精和伊红（H&E）染色进行评估。
用 HNS 灌洗液进行灌流射频消融会产生凝固性坏死，以及一些延迟的组织病理学变化，有效消融的范围更深。心内膜、心外膜或顺序单极 HNS 消融可能无法获得心室心肌的透壁性。
