PURPOSE: This study assessed the feasibility of modification of atrioventricular (AV) conduction under direct vision with a new ablation system using laser energy. METHODS AND RESULTS: In 23 anesthetized dogs, a combined laser and balloon-tipped endoscope was introduced into the right atrium after right thoracotomy. Koch's triangle was easily identified in all dogs endoscopically. Nd:YAG laser energy was delivered through an optical fiber positioned inside the saline-filled balloon to the middle portion of Koch's triangle in eight dogs (mid-Koch group) and to the posterior portion in 12 dogs (postero-Koch group). Complete AV block was achieved in five of eight dogs in the mid-Koch group. In the postero-Koch group, anterograde Wenckebach cycle length increased significantly from 178+/-23 ms to 202+/-37 ms (P = 0.008). CONCLUSION: Selective laser ablation of Koch's triangle is feasible with a combined laser and balloon-tipped endoscope.
PURPOSE: This study assessed the feasibility of modification of atrioventricular (AV) conduction under direct vision with a new ablation system using laser energy. METHODS AND RESULTS: In 23 anesthetized dogs, a combined laser and balloon-tipped endoscope was introduced into the right atrium after right thoracotomy. Koch's triangle was easily identified in all dogs endoscopically. Nd:YAG laser energy was delivered through an optical fiber positioned inside the saline-filled balloon to the middle portion of Koch's triangle in eight dogs (mid-Koch group) and to the posterior portion in 12 dogs (postero-Koch group). Complete AV block was achieved in five of eight dogs in the mid-Koch group. In the postero-Koch group, anterograde Wenckebach cycle length increased significantly from 178+/-23 ms to 202+/-37 ms (P = 0.008). CONCLUSION: Selective laser ablation of Koch's triangle is feasible with a combined laser and balloon-tipped endoscope.
Authors: Hakan Oral; Christoph Scharf; Aman Chugh; Burr Hall; Peter Cheung; Eric Good; Srikar Veerareddy; Frank Pelosi; Fred Morady Journal: Circulation Date: 2003-10-13 Impact factor: 29.690
Authors: L Littmann; R H Svenson; S Bharati; M Lev; C H Chuang; P Kempler; R Splinter; J R Tuntelder; G P Tatsis Journal: J Am Coll Cardiol Date: 1993-02 Impact factor: 24.094