Lee B I, Gottdiener J S, Fletcher R D, Rodriguez E R, Ferrans V J
Circulation. 1985 Mar;71(3):579-86. doi: 10.1161/01.cir.71.3.579.
To characterize and compare the effects of transcatheter laser and electrical energy on endocardium, 35 laser pulses were delivered to the endocardial surfaces of isolated canine hearts, and 33 endocardial lesions were produced by the transarterial delivery of either transcatheter laser irradiation or electrical shock in closed-chest anesthetized dogs. Laser-induced lesion dimensions in vitro and in vivo increased with increased total dose of energy; however, the lesions produced in vivo were different in morphology and were significantly larger than lesions produced by equivalent doses of energy delivered in vitro (p less than .05). Endocardial lesions produced in vivo by laser at 40 and 80 J (7.9 X 5.4 X 6.6 and 7.9 X 5.1 X 7.5 mm) were comparable in gross morphology and size to those produced by electrical shock at 100 and 200 J (8.5 X 6.6 X 6.6 and 10.0 X 8.5 X 8.2 mm, respectively; p = NS), but transcatheter electrode shock produced significantly more ventricular tachycardia (p less than .003), premature ventricular beats in the 7 min after energy discharge (p less than .05), and wall motion abnormality (p less than .005). Transcatheter laser photoablation can create controlled endocardial lesions with less energy and fewer deleterious effects than transcatheter electrode shock.
为了描述和比较经导管激光和电能对心内膜的影响，对离体犬心的心内膜表面施加35个激光脉冲，并在开胸麻醉犬中通过经动脉输送经导管激光照射或电击产生33个心内膜损伤。体外和体内激光诱导的损伤尺寸随总能量剂量增加而增大；然而，体内产生的损伤在形态上有所不同，且明显大于体外输送等量能量产生的损伤（p<0.05）。体内用40和80焦耳激光产生的心内膜损伤（7.9×5.4×6.6和7.9×5.1×7.5毫米）在大体形态和大小上与100和200焦耳电击产生的损伤相当（分别为8.5×6.6×6.6和10.0×8.5×8.2毫米；p=无显著性差异），但经导管电极电击产生的室性心动过速明显更多（p<0.003），能量释放后7分钟内室性早搏更多（p<0.05），以及壁运动异常更多（p<0.005）。与经导管电极电击相比，经导管激光光消融能用更少的能量和更少的有害影响产生可控的心内膜损伤。
