We report ten successful experiments of transvenous destruction of the His bundle by laser radiation. An endoscope coupled with a special laser catheter was introduced through the jugular vein into the right atrium of dogs. The tip of the laser catheter was positioned in front of A-V conduction system under visual control using anatomic landmarks. Injection of saline solution coaxial with the laser power-transmitting fiber was performed before and during laser coagulation. Twenty watts constant wave Nd-YAG laser operating at 1.06 micron was enough to produce complete A-V block in approximately 15 sec. The safety of the proposed technique is especially discussed.
Histological investigation of the dog's myocardium performed 7 and 25 days after irradiation with different doses of Nd-YAG laser show that the damage zone has the shape of a hollow sphere with minor changes in cardiomyocytes in the central part of the sphere. The small blood vessels in the irradiated zone remained undamaged as well. A tentative explanation of the physical process that leads to this type of coagulation zone is given.
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