Catheter ablation: an ongoing revolution

Raymond-Paquin, Alexandre; Andrade, Jason G.; Macle, Laurent

doi:10.21037/jtd.2019.02.20

Cited by 9 publications

(6 citation statements)

References 24 publications

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“…Ablation techniques are commonly used in medicine for the removal of diseased (especially cancerous) tissues [ 1 , 2 ]. The process involves the application of various damage-causing methods to induce instant and focused necrosis in the region of interest [ 3 , 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Oxidative Effects during Irreversible Electroporation of Melanoma Cells—In Vitro Study

et al. 2020

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Irreversible electroporation (IRE) is today used as an alternative to surgery for the excision of cancer lesions. This study aimed to investigate the oxidative and cytotoxic effects the cells undergo during irreversible electroporation using IRE protocols. To do so, we used IRE-inducing pulsed electric fields (PEFs) (eight pulses of 0.1 ms duration and 2–4 kV/cm intensity) and compared their effects to those of PEFs of intensities below the electroporation threshold (eight pulses, 0.1 ms, 0.2–0.4 kV/cm) and the PEFs involving elongated pulses (eight pulses, 10 ms, 0.2–0.4 kV/cm). Next, to follow the morphology of the melanoma cell membranes after treatment with the PEFs, we analyzed the permeability and integrity of their membranes and analyzed the radical oxygen species (ROS) bursts and the membrane lipids’ oxidation. Our data showed that IRE-induced high cytotoxic effect is associated both with irreversible cell membrane disruption and ROS-associated oxidation, which is occurrent also in the low electric field range. It was shown that the viability of melanoma cells characterized by similar ROS content and lipid membrane oxidation after PEF treatment depends on the integrity of the membrane system. Namely, when the effects of the PEF on the membrane are reversible, aside from the high level of ROS and membrane oxidation, the cell does not undergo cell death.

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Section: Introductionmentioning

confidence: 99%

Oxidative Effects during Irreversible Electroporation of Melanoma Cells—In Vitro Study

et al. 2020

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“…In a previous global survey, APT-related deaths accounted for a quarter of perioperative deaths of AF-CA (1). In recent years, along with the increasing number of AF-CA worldwide, APT cases have risen rapidly (7). Several reasons might be responsible for APT in the AF-CA procedure: the need for transseptal punctures, the intense and long catheter manipulation in the atrium, using high-power ablation with risk of steam pops, and the need for intense systemic anticoagulation.…”

Section: Introductionmentioning

confidence: 99%

Direct autotransfusion in the management of acute pericardial tamponade during catheter ablation for atrial fibrillation: An imperfect but practical method

Zhao

Liu

et al. 2022

Front. Cardiovasc. Med.

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BackgroundAcute pericardial tamponade (APT) is one of the most serious complications of catheter ablation for atrial fibrillation (AF-CA). Direct autotransfusion (DAT) is a method of reinjecting pericardial blood directly into patients through vein access without a cell-salvage system. Data regarding DAT for APT are rare and provide limited information. Our present study aims to further investigate the safety and feasibility of DAT in the management of APT during the AF-CA procedure.Methods and resultsWe retrospectively reviewed 73 cases of APT in the perioperative period of AF-CA from January 2014 to October 2021 at our institution, among whom 46 were treated with DAT. All included patients successfully received emergency pericardiocentesis through subxiphoid access guided by X-ray. Larger volumes of aspirated pericardial blood (658.4 ± 545.2 vs. 521.2 ± 464.9 ml), higher rates of bridging anticoagulation (67.4 vs. 37.0%), and surgical repair (6 vs. 0) were observed in patients with DAT than without. Moreover, patients with DAT were less likely to complete AF-CA procedures (32/46 vs. 25/27) and had a lower incidence of APT first presented in the ward (delayed presentation) (8/46 vs. 9/27). There was no difference in major adverse events (death/disseminated intravascular coagulation/multiple organ dysfunction syndrome and clinical thrombosis) (0/0/1/0 vs. 1/0/0/0), other potential DAT-related complications (fever/infection and deep venous thrombosis) (8/5/2 vs. 5/3/1), and length of hospital stay (11.4 ± 11.6 vs. 8.3 ± 4.7 d) between two groups.ConclusionDAT could be a feasible and safe method to deal with APT during AF-CA procedure.

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“…While ablation procedures in both adult and pediatric populations have high success rates and relatively low risk of significant complications 1,2,3 , pediatric procedures pose additional technical challenges due to smaller size and unique congenital heart disease (CHD) 4 . Unintended catheter movement during ablation procedures can risk creating unwanted lesions or intracardiac injuries especially during ablations performed close to the compact atrioventricular (AV) node such as cases of septal accessory pathways or AV-nodal re-entrant tachycardia (AVNRT) 3,5,6 .…”

Section: Introductionmentioning

confidence: 99%

Muscle Usage and Workload Assessment of Cardiac Ablation Procedure with the Use of a Novel Catheter Torque Tool in a Pediatric Simulator

Mass

Kumthekar

Clark

et al. 2022

Preprint

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Background: Cardiac ablation catheters are small in diameter and pose ergonomic challenges that can affect catheter stability. Significant finger dexterity and strength are necessary to maneuver them safely. We evaluated a novel torque tool to reduce muscle activation when manipulating catheters and improve perceived workload of ablation tasks. Objective: Evaluate measurable success, user perception of workload, and muscle usage when completing a simulated ablation task with and without the use of a catheter torque tool. Methods: Cardiology attendings and fellows were fitted with surface electromyographic (EMG) sensors on 6 key muscle groups in the left hand and forearm. A standard ablation catheter was inserted into a pediatric cardiac ablation simulator and subjects navigated the catheter tip to 6 specific electrophysiologic targets, including a 1-minute simulated radiofrequency ablation lesion. Time to complete the task, number of attempts required to complete the lesion, and EMG activity normalized to percentage of maximum voluntary contraction was collected throughout the task. The task was completed 4 times, twice with and twice without the torque tool, in randomized order. A NASA Task Load Index survey was completed by the participant at the conclusion of each task. Results: Time to complete the task and number of attempts to create a lesion were not altered by the tool. Subjectively, participants reported a significant decrease in physical demand, effort and frustration, and a significant increase in performance. Muscle activation was decreased in 4 of 6 muscle groups. Conclusion: The catheter torque tool may improve the perceived workload of cardiac ablation procedures and reduce muscle fatigue caused by manipulating catheters. This may result in improved catheter stability and increased procedural safety.

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Catheter ablation: an ongoing revolution

Cited by 9 publications

References 24 publications

Oxidative Effects during Irreversible Electroporation of Melanoma Cells—In Vitro Study

Oxidative Effects during Irreversible Electroporation of Melanoma Cells—In Vitro Study

Direct autotransfusion in the management of acute pericardial tamponade during catheter ablation for atrial fibrillation: An imperfect but practical method

Muscle Usage and Workload Assessment of Cardiac Ablation Procedure with the Use of a Novel Catheter Torque Tool in a Pediatric Simulator

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