Feasibility of Radiofrequency Powered, Thermal Balloon Ablation of Atrioventricular Bypass Tracts Via the Coronary Sinus: In Vivo Canine Studies

DANIEL B. FRAM, ELLISON BERNS, THOMAS ARETZ, LINDA D. GILLAM, JOSEPH S. MIKAN, DAVID WATERS, RAYMOND G. McKAY

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Radiofeequency catheter ablation of left sided accessory pathways is technically demanding and usually requires left heart catheterization. The feasibility of creating lesions from within the coronary sinus of sufficient size to ablate accessory pathways in humans using a thermal balloon catheter was studied in 20 dogs. In group 1 (n == 14), 17 thermal inflations were performed in 12 dogs at either 70°, 80°, or 90°C each for 30 or 60 seconds (in 2 dogs two non‐thermal control inflations were performed). Animals were sacrificed 6.3 ± 1.6 days later. In group 2 (n = 6), seven thermal inflations were performed at 90°C each for 180, 300, or 360 seconds. Group 2 animals received antiplatelet and anticoagulant therapy for 1 week and were sacrificed at 13 ± 10.7 days. In both groups, hemodynamic, angiographic, and electrocardiographic studies were performed at baseline, 1 hour after inflation, and prior to sacrifice. All dogs remained clinically stable throughout the procedure and no complications were attributed to the effect of thermal inflation. Thermal lesions measured 14.4 ± 4.4 mm in length and extended from the coronary sinus intima to a mean depth of 2.9 ± 1.2 mm (range 1.4‐6.5 mm). Group 2 lesions were significantly deeper than group 1 lesions (P = 0.03). Of the 24 thermal lesions created, atrial necrosis was present in 23 and ventricular necrosis in 11. In all lesions there was some degree of either atrial necrosis, ventricular necrosis, or both. A variable degree of coronary sinus thrombus was present in 18 dogs without clinical sequelae. It is concluded that radiofrequency balloon heating via the coronary sinus can create thermal lesions in the atrioventricular sulcus of dogs that may be of sufficient size to ablate accessory left‐sided pathways in humans. (PACE 1995; 18: 1518‐1530)

Original languageEnglish (US)
Pages (from-to)1518-1530
Number of pages13
JournalPacing and Clinical Electrophysiology
Volume18
Issue number8
DOIs
StatePublished - Jan 1 1995
Externally publishedYes

Fingerprint

Coronary Sinus
Canidae
Economic Inflation
Hot Temperature
Dogs
Necrosis
Catheter Ablation
Cardiac Catheterization
Heating
Anticoagulants
Thrombosis
Catheters
Hemodynamics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

FRAM, DANIEL B. ; BERNS, ELLISON ; ARETZ, THOMAS ; GILLAM, LINDA D. ; MIKAN, JOSEPH S. ; WATERS, DAVID ; McKAY, RAYMOND G. / Feasibility of Radiofrequency Powered, Thermal Balloon Ablation of Atrioventricular Bypass Tracts Via the Coronary Sinus : In Vivo Canine Studies. In: Pacing and Clinical Electrophysiology. 1995 ; Vol. 18, No. 8. pp. 1518-1530.
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abstract = "Radiofeequency catheter ablation of left sided accessory pathways is technically demanding and usually requires left heart catheterization. The feasibility of creating lesions from within the coronary sinus of sufficient size to ablate accessory pathways in humans using a thermal balloon catheter was studied in 20 dogs. In group 1 (n == 14), 17 thermal inflations were performed in 12 dogs at either 70°, 80°, or 90°C each for 30 or 60 seconds (in 2 dogs two non‐thermal control inflations were performed). Animals were sacrificed 6.3 ± 1.6 days later. In group 2 (n = 6), seven thermal inflations were performed at 90°C each for 180, 300, or 360 seconds. Group 2 animals received antiplatelet and anticoagulant therapy for 1 week and were sacrificed at 13 ± 10.7 days. In both groups, hemodynamic, angiographic, and electrocardiographic studies were performed at baseline, 1 hour after inflation, and prior to sacrifice. All dogs remained clinically stable throughout the procedure and no complications were attributed to the effect of thermal inflation. Thermal lesions measured 14.4 ± 4.4 mm in length and extended from the coronary sinus intima to a mean depth of 2.9 ± 1.2 mm (range 1.4‐6.5 mm). Group 2 lesions were significantly deeper than group 1 lesions (P = 0.03). Of the 24 thermal lesions created, atrial necrosis was present in 23 and ventricular necrosis in 11. In all lesions there was some degree of either atrial necrosis, ventricular necrosis, or both. A variable degree of coronary sinus thrombus was present in 18 dogs without clinical sequelae. It is concluded that radiofrequency balloon heating via the coronary sinus can create thermal lesions in the atrioventricular sulcus of dogs that may be of sufficient size to ablate accessory left‐sided pathways in humans. (PACE 1995; 18: 1518‐1530)",
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Feasibility of Radiofrequency Powered, Thermal Balloon Ablation of Atrioventricular Bypass Tracts Via the Coronary Sinus : In Vivo Canine Studies. / FRAM, DANIEL B.; BERNS, ELLISON; ARETZ, THOMAS; GILLAM, LINDA D.; MIKAN, JOSEPH S.; WATERS, DAVID; McKAY, RAYMOND G.

In: Pacing and Clinical Electrophysiology, Vol. 18, No. 8, 01.01.1995, p. 1518-1530.

Research output: Contribution to journalArticle

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T2 - In Vivo Canine Studies

AU - FRAM, DANIEL B.

AU - BERNS, ELLISON

AU - ARETZ, THOMAS

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