Thomas J Buist1,2, Marijn H A Groen2, Fred H M Wittkampf2, Peter Loh2, Pieter A F M Doevendans2,3,4, René van Es2, Arif Elvan5,6. 1. Heart Centre, Isala Hospital, Dr. Van Heesweg 2, 8025 AB, Zwolle, The Netherlands. 2. Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. 3. Netherlands Heart Institute, Utrecht, The Netherlands. 4. Central Military Hospital, Utrecht, The Netherlands. 5. Heart Centre, Isala Hospital, Dr. Van Heesweg 2, 8025 AB, Zwolle, The Netherlands. t.j.buist@isala.nl. 6. Department of Cardiology, Isala Heart Centre, Dr. Van Heesweg 2, 8025 AB, Zwolle, The Netherlands. t.j.buist@isala.nl.
Abstract
INTRODUCTION: Previous studies demonstrated that the coronary sinus (CS) is an important target for ablation in persistent atrial fibrillation. However, radiofrequency ablation in the CS is associated with coronary vessel damage and tamponade. Animal data suggest irreversible electroporation (IRE) ablation can be a safe ablation modality in vicinity of coronary arteries. We investigated the feasibility of IRE in the CS in a porcine model. METHODS: Ablation and pacing was performed in the CS in six pigs (weight 60-75 kg) using a modified 9-French steerable linear hexapolar Tip-Versatile Ablation Catheter. Pacing maneuvers were performed from distal to proximal segments of the CS to assess atrial capture thresholds before and after IRE application. IRE ablations were performed with 100 J IRE pulses. After 3-week survival animals were euthanized and histological sections from the CS were analyzed. RESULTS: A total of 27 IRE applications in six animals were performed. Mean peak voltage was 1509 ± 36 V, with a mean peak current of 22.9 ± 1.0 A. No complications occurred during procedure and 3-week survival. At 30 min post ablation 100% isolation was achieved in all animals. At 3 weeks follow-up pacing thresholds were significant higher as compared to baseline. Histological analysis showed transmural ablation lesions in muscular sleeves surrounding the CS. CONCLUSION: IRE ablation of the musculature along the CS using a multi-electrode catheter is feasible in a porcine model.
INTRODUCTION: Previous studies demonstrated that the coronary sinus (CS) is an important target for ablation in persistent atrial fibrillation. However, radiofrequency ablation in the CS is associated with coronary vessel damage and tamponade. Animal data suggest irreversible electroporation (IRE) ablation can be a safe ablation modality in vicinity of coronary arteries. We investigated the feasibility of IRE in the CS in a porcine model. METHODS: Ablation and pacing was performed in the CS in six pigs (weight 60-75 kg) using a modified 9-French steerable linear hexapolar Tip-Versatile Ablation Catheter. Pacing maneuvers were performed from distal to proximal segments of the CS to assess atrial capture thresholds before and after IRE application. IRE ablations were performed with 100 J IRE pulses. After 3-week survival animals were euthanized and histological sections from the CS were analyzed. RESULTS: A total of 27 IRE applications in six animals were performed. Mean peak voltage was 1509 ± 36 V, with a mean peak current of 22.9 ± 1.0 A. No complications occurred during procedure and 3-week survival. At 30 min post ablation 100% isolation was achieved in all animals. At 3 weeks follow-up pacing thresholds were significant higher as compared to baseline. Histological analysis showed transmural ablation lesions in muscular sleeves surrounding the CS. CONCLUSION: IRE ablation of the musculature along the CS using a multi-electrode catheter is feasible in a porcine model.
Authors: Kars Neven; René van Es; Vincent van Driel; Harry van Wessel; Herma Fidder; Aryan Vink; Pieter Doevendans; Fred Wittkampf Journal: Circ Arrhythm Electrophysiol Date: 2017-05
Authors: Peter Loh; René van Es; Marijn H A Groen; Kars Neven; Wil Kassenberg; Fred H M Wittkampf; Pieter A Doevendans Journal: Circ Arrhythm Electrophysiol Date: 2020-09-08