Irrigated Needle Ablation Creates Larger and More Transmural Ventricular Lesions Compared With Standard Unipolar Ablation in an Ovine Model.
Circ Arrhythm Electrophysiol. 2015 Dec; 8(6):1498-506.CA

Abstract

BACKGROUND

Ventricular tachycardia recurrence can occur after ventricular tachycardia ablation because of incomplete and nontransmural ventricular lesion formation. We sought to compare the lesions made by a novel irrigated needle catheter to conventional radiofrequency lesions.

METHODS AND RESULTS

Thirteen female sheep (4.6±0.7 years, 54±8 kg) were studied. In 7 sheep, 60-s radiofrequency applications were performed using an irrigated needle catheter. In 6 sheep, conventional lesions were made using a 4-mm irrigated catheter. 1.5T in vivo and high-density magnetic resonance imaging (9.4T) were performed on explanted hearts from animals receiving needle radiofrequency. Conventional lesion volume was calculated as (1/6)×π×(A×B(2)+C×D(2)/2). Needle lesion volume was measured as Σ(π×r(2))/2 with a slice thickness of 1 mm. The dimensions of all lesions were also measured on gross pathology. Additional histological analysis of the needle lesions was performed. One hundred twenty endocardial left ventricular ablation lesions (conventional, n=60; needle, n=60) were created. At necropsy, more lesions were found using needle versus conventional radiofrequency (90% versus 75%; P<0.05). Comparing needle versus conventional radiofrequency: lesion volume was larger (1030±362 versus 488±384 mm(3); P<0.001), lesion depth was increased (9.9±2.7 versus 5±2.4 mm; P<0.001), and more transmural lesions were created (62.5% versus 17%; P<0.01). Pericardial contrast injection was observed in 4 apical attempts using needle radiofrequency, however, with no adverse effects. Steam pops occurred in 3 attempts using conventional radiofrequency.

CONCLUSIONS

Irrigated needle ablation is associated with more frequent, larger, deeper, and more often transmural lesions compared with conventional irrigated ablation. This technology might be of value to treat intramural or epicardial ventricular tachycardia substrates resistant to conventional ablation.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Berte B

From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).

MeSH

AnimalsBiopsyCardiac CathetersCardiac Pacing, ArtificialCatheter AblationDisease Models, AnimalElectrophysiologic Techniques, CardiacEquipment DesignFemaleHeart VentriclesMagnetic Resonance ImagingNeedlesSheepTachycardia, VentricularTherapeutic IrrigationVentricular Fibrillation

Pub Type(s)

Comparative Study

Journal Article

Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26359480

Citation

Berte, Benjamin, et al. "Irrigated Needle Ablation Creates Larger and More Transmural Ventricular Lesions Compared With Standard Unipolar Ablation in an Ovine Model." Circulation. Arrhythmia and Electrophysiology, vol. 8, no. 6, 2015, pp. 1498-506.

Berte B, Cochet H, Magat J, et al. Irrigated Needle Ablation Creates Larger and More Transmural Ventricular Lesions Compared With Standard Unipolar Ablation in an Ovine Model. Circ Arrhythm Electrophysiol. 2015;8(6):1498-506.

Berte, B., Cochet, H., Magat, J., Naulin, J., Ghidoli, D., Pillois, X., Casassus, F., Yamashita, S., Mahida, S., Derval, N., Hocini, M., Quesson, B., Bernus, O., Weerasooriya, R., Haïssaguerre, M., Sacher, F., & Jaïs, P. (2015). Irrigated Needle Ablation Creates Larger and More Transmural Ventricular Lesions Compared With Standard Unipolar Ablation in an Ovine Model. Circulation. Arrhythmia and Electrophysiology, 8(6), 1498-506. https://doi.org/10.1161/CIRCEP.115.002963

Berte B, et al. Irrigated Needle Ablation Creates Larger and More Transmural Ventricular Lesions Compared With Standard Unipolar Ablation in an Ovine Model. Circ Arrhythm Electrophysiol. 2015;8(6):1498-506. PubMed PMID: 26359480.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Irrigated Needle Ablation Creates Larger and More Transmural Ventricular Lesions Compared With Standard Unipolar Ablation in an Ovine Model. AU - Berte,Benjamin, AU - Cochet,Hubert, AU - Magat,Julie, AU - Naulin,Jérôme, AU - Ghidoli,Daniele, AU - Pillois,Xavier, AU - Casassus,Frédéric, AU - Yamashita,Seigo, AU - Mahida,Saagar, AU - Derval,Nicolas, AU - Hocini,Mélèze, AU - Quesson,Bruno, AU - Bernus,Olivier, AU - Weerasooriya,Rukshen, AU - Haïssaguerre,Michel, AU - Sacher,Frédéric, AU - Jaïs,Pierre, Y1 - 2015/09/10/ PY - 2015/03/11/received PY - 2015/08/19/accepted PY - 2015/9/12/entrez PY - 2015/9/12/pubmed PY - 2016/4/12/medline KW - ablation techniques KW - arrhythmias, cardiac KW - catheter ablation KW - magnetic resonance imaging KW - model KW - s, animal SP - 1498 EP - 506 JF - Circulation. Arrhythmia and electrophysiology JO - Circ Arrhythm Electrophysiol VL - 8 IS - 6 N2 - BACKGROUND: Ventricular tachycardia recurrence can occur after ventricular tachycardia ablation because of incomplete and nontransmural ventricular lesion formation. We sought to compare the lesions made by a novel irrigated needle catheter to conventional radiofrequency lesions. METHODS AND RESULTS: Thirteen female sheep (4.6±0.7 years, 54±8 kg) were studied. In 7 sheep, 60-s radiofrequency applications were performed using an irrigated needle catheter. In 6 sheep, conventional lesions were made using a 4-mm irrigated catheter. 1.5T in vivo and high-density magnetic resonance imaging (9.4T) were performed on explanted hearts from animals receiving needle radiofrequency. Conventional lesion volume was calculated as (1/6)×π×(A×B(2)+C×D(2)/2). Needle lesion volume was measured as Σ(π×r(2))/2 with a slice thickness of 1 mm. The dimensions of all lesions were also measured on gross pathology. Additional histological analysis of the needle lesions was performed. One hundred twenty endocardial left ventricular ablation lesions (conventional, n=60; needle, n=60) were created. At necropsy, more lesions were found using needle versus conventional radiofrequency (90% versus 75%; P<0.05). Comparing needle versus conventional radiofrequency: lesion volume was larger (1030±362 versus 488±384 mm(3); P<0.001), lesion depth was increased (9.9±2.7 versus 5±2.4 mm; P<0.001), and more transmural lesions were created (62.5% versus 17%; P<0.01). Pericardial contrast injection was observed in 4 apical attempts using needle radiofrequency, however, with no adverse effects. Steam pops occurred in 3 attempts using conventional radiofrequency. CONCLUSIONS: Irrigated needle ablation is associated with more frequent, larger, deeper, and more often transmural lesions compared with conventional irrigated ablation. This technology might be of value to treat intramural or epicardial ventricular tachycardia substrates resistant to conventional ablation. SN - 1941-3084 UR - https://www.unboundmedicine.com/medline/citation/26359480/Irrigated_Needle_Ablation_Creates_Larger_and_More_Transmural_Ventricular_Lesions_Compared_With_Standard_Unipolar_Ablation_in_an_Ovine_Model_ DB - PRIME DP - Unbound Medicine ER -

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Irrigated Needle Ablation Creates Larger and More Transmural Ventricular Lesions Compared With Standard Unipolar Ablation in an Ovine Model.Circ Arrhythm Electrophysiol. 2015 Dec; 8(6):1498-506.CA