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Cooled needle catheter ablation creates deeper and wider lesions than irrigated tip catheter ablation.
J Cardiovasc Electrophysiol. 2005 May; 16(5):508-15.JC

Abstract

OBJECTIVES

To design and test a catheter that could create deeper ablation lesions.

BACKGROUND

Endocardial radiofrequency (RF) ablation is unable to reliably create transmural ventricular lesions. We designed an intramural needle ablation catheter with an internally cooled 1.1-mm diameter straight needle that could be advanced up to 14 mm into the myocardium. The prototype catheter was compared with an irrigated tip ablation catheter.

METHODS

Ablation lesions were created under general anesthesia in 14 male sheep (weight 44 +/- 7.3 kg) with fluoroscopic guidance. Each of the catheters was used to create two ablation lesions at randomly allocated positions within the left ventricle. The irrigation rate, target temperature, and maximum power were: 20 mL/min, 85 degrees C, 50 W for the intramural needle catheter and 20 mL/min, 50 degrees C, 50 W for the irrigated tip catheter, respectively. All ablations were performed for 2 minutes. After the last ablation, blue tetrazolium (12.5 mg/kg) was infused intravenously. The heart was removed via a left thoracotomy after monitoring the sheep for one hour.

RESULTS

There was no evidence of cardiac tamponade in any sheep. The intramural needle catheter lesions were significantly wider (10.9 +/- 2.8 mm vs 10.1 +/- 2.4 mm, P = 0.01), deeper (9.6 +/- 2.0 mm vs 7.0 +/- 1.3 mm, P = 0.01), and more likely to be transmural (38% vs 0%, P = 0.03).

CONCLUSIONS

Cooled intramural needle ablation creates lesions that are significantly deeper and wider than endocardial RF ablation using an irrigated tip catheter in sheep hearts. This technology may be useful in treating ventricular tachycardia resistant to conventional ablation techniques.

Authors+Show Affiliations

Thiagalingam A
Department of Cardiology, Westmead Hospital, Westmead, NSW 2145, Australia. aravinda@westgate.wh.usyd.edu.au
Pouliopoulos J
No affiliation info available
Barry MA
No affiliation info available
Boyd AC
No affiliation info available
Eipper V
No affiliation info available
Yung T
No affiliation info available
Ross DL
No affiliation info available
Kovoor P
No affiliation info available

MeSH

Analysis of VarianceAnimalsCatheter AblationCold TemperatureEquipment DesignFluoroscopyMaleMyocardiumSheep

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15877622

Citation

Thiagalingam, Aravinda, et al. "Cooled Needle Catheter Ablation Creates Deeper and Wider Lesions Than Irrigated Tip Catheter Ablation." Journal of Cardiovascular Electrophysiology, vol. 16, no. 5, 2005, pp. 508-15.
Thiagalingam A, Pouliopoulos J, Barry MA, et al. Cooled needle catheter ablation creates deeper and wider lesions than irrigated tip catheter ablation. J Cardiovasc Electrophysiol. 2005;16(5):508-15.
Thiagalingam, A., Pouliopoulos, J., Barry, M. A., Boyd, A. C., Eipper, V., Yung, T., Ross, D. L., & Kovoor, P. (2005). Cooled needle catheter ablation creates deeper and wider lesions than irrigated tip catheter ablation. Journal of Cardiovascular Electrophysiology, 16(5), 508-15.
Thiagalingam A, et al. Cooled Needle Catheter Ablation Creates Deeper and Wider Lesions Than Irrigated Tip Catheter Ablation. J Cardiovasc Electrophysiol. 2005;16(5):508-15. PubMed PMID: 15877622.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cooled needle catheter ablation creates deeper and wider lesions than irrigated tip catheter ablation. AU - Thiagalingam,Aravinda, AU - Pouliopoulos,Jim, AU - Barry,Michael Anthony, AU - Boyd,Anita C, AU - Eipper,Vicki, AU - Yung,Teresa, AU - Ross,David L, AU - Kovoor,Pramesh, PY - 2005/5/10/pubmed PY - 2005/8/10/medline PY - 2005/5/10/entrez SP - 508 EP - 15 JF - Journal of cardiovascular electrophysiology JO - J Cardiovasc Electrophysiol VL - 16 IS - 5 N2 - OBJECTIVES: To design and test a catheter that could create deeper ablation lesions. BACKGROUND: Endocardial radiofrequency (RF) ablation is unable to reliably create transmural ventricular lesions. We designed an intramural needle ablation catheter with an internally cooled 1.1-mm diameter straight needle that could be advanced up to 14 mm into the myocardium. The prototype catheter was compared with an irrigated tip ablation catheter. METHODS: Ablation lesions were created under general anesthesia in 14 male sheep (weight 44 +/- 7.3 kg) with fluoroscopic guidance. Each of the catheters was used to create two ablation lesions at randomly allocated positions within the left ventricle. The irrigation rate, target temperature, and maximum power were: 20 mL/min, 85 degrees C, 50 W for the intramural needle catheter and 20 mL/min, 50 degrees C, 50 W for the irrigated tip catheter, respectively. All ablations were performed for 2 minutes. After the last ablation, blue tetrazolium (12.5 mg/kg) was infused intravenously. The heart was removed via a left thoracotomy after monitoring the sheep for one hour. RESULTS: There was no evidence of cardiac tamponade in any sheep. The intramural needle catheter lesions were significantly wider (10.9 +/- 2.8 mm vs 10.1 +/- 2.4 mm, P = 0.01), deeper (9.6 +/- 2.0 mm vs 7.0 +/- 1.3 mm, P = 0.01), and more likely to be transmural (38% vs 0%, P = 0.03). CONCLUSIONS: Cooled intramural needle ablation creates lesions that are significantly deeper and wider than endocardial RF ablation using an irrigated tip catheter in sheep hearts. This technology may be useful in treating ventricular tachycardia resistant to conventional ablation techniques. SN - 1045-3873 UR - https://www.unboundmedicine.com/medline/citation/15877622/Cooled_needle_catheter_ablation_creates_deeper_and_wider_lesions_than_irrigated_tip_catheter_ablation_ DB - PRIME DP - Unbound Medicine ER -