Comparison of In Vivo Tissue Temperature Profile and Lesion Geometry for Radiofrequency Ablation With a Saline-Irrigated Electrode Versus Temperature Control in a Canine Thigh Muscle Preparation

Nakagawa, Hiroshi; Yamanashi, William S.; Piťha, Jan; Arruda, Maurício; Wang, Xanzhung; Ohtomo, Kenichiro; Beckman, Karen J.; McClelland, James H.; Lazzara, Ralph; Jackman, Warren M.

doi:10.1161/01.cir.91.8.2264

Cited by 573 publications

(443 citation statements)

References 29 publications

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“…Cooled RF ablation was more effective in terminating VT in the short-term, which is consistent with the production of a larger lesion, as seen in prior studies in animal models, in vitro preparations, and anecdotal observations. [7][8][9][10][11] Ablation was most effective at sites identified as likely isthmuses on the basis of entrainment and the presence of an isolated potential, as was previously reported. 5 In the present study, the termination rate at isthmus sites was significantly higher in the cooled RF group, suggesting that these reentry circuit isthmuses often exceed the width and depth of a standard RF lesion.…”

Section: Discussionsupporting

confidence: 73%

Saline-Cooled Versus Standard Radiofrequency Catheter Ablation for Infarct-Related Ventricular Tachycardias

et al. 2001

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Background-Saline cooling of the electrode during radiofrequency (RF) ablation increases lesion size in animal models.If cooled RF also increases lesion size in human infarcts, it should facilitate the termination of ventricular tachycardia (VT). Methods and Results-In 66 patients with VT due to prior infarction, 366 ablation sites, which were classified by entrainment and isolated potentials followed by ablation during VT with either standard RF energy (247 sites

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Section: Discussionsupporting

confidence: 73%

Saline-Cooled Versus Standard Radiofrequency Catheter Ablation for Infarct-Related Ventricular Tachycardias

et al. 2001

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“…RF energy was delivered according to a safe protocol found in experimental studies. 8,9 This consisted of temperature-controlled RF delivery with a power limit of 50 W, a target temperature of 45°C, and an infusion rate of 30 mL/min during RF delivery. Procedural success was defined as (1) termination and noninducibility of LAMRT and (2) conduction block across the tachycardia isthmus.…”

Section: Rf Ablationmentioning

confidence: 99%

Characterization of Reentrant Circuits in Left Atrial Macroreentrant Tachycardia

et al. 2002

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Background-Left atrial macroreentrant tachycardia (LAMRT) has not been characterized in detail.Methods and Results-Twenty-eight patients with LAMRT, including 4 patients with ablated typical atrial flutter (AFL), underwent electroanatomic mapping of the left atrium (LA) between February 1999 and October 2001. LA maps were performed during LAMRT in 26 patients and during sinus rhythm in 2 patients. Electrically silent areas or continuous lines of double potentials were identified as acquired anatomic barriers in all patients. In 23 of 26 patients with LAMRT mapping, 42 reentry circuits with a protected isthmus were identified. The isthmus was 11.8Ϯ5.9 mm wide, with the maximal amplitude of 0.07 to 3.61 mV. Radiofrequency pulses terminated all LAMRTs in 23 patients and resulted in conduction block across the isthmus in 20 patients. In 2 patients with sinus mapping, all identified isthmuses were ablated. Additionally, AFL was induced and ablated in 6 patients. Atrial tachycardia recurred in 4 patients: 3 patients without validated block across the isthmus presented with recurrence of the same LAMRT, and 1 patient without ablated cavotricuspid isthmus presented with AFL. All tachycardias were abolished during a second procedure. Of 25 patients with identified isthmuses, 20 patients were without atrial arrhythmia and 5 had only atrial fibrillation during a median follow-up of 14 months. Conclusion-The reentry circuit with a protected isthmus can be identified in 89% patients with LAMRT by electroanatomic mapping. The isthmuses were amenable to radiofrequency applications in most patients. No atrial tachycardia recurred in any patients with isthmus block.

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“…Animal studies and clinical experience with epicardial ablation in the coronary veins using saline-irrigated electrodes have the potential for damage to the adjacent coronary artery. 30,31) Recently, Shimoike, et al reported two cases of successful ablation of LV outflow VTs from an endocardial site. 32) However, this site (left fibrous trigone) plays an important role in bridging aortic and mitral valve annuli.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Catheter Ablation of Ventricular Tachycardia from the Anterobasal Left Ventricle.

et al. 2000

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HE most common form of left-sided idiopathic ventricular tachycardia (VT) arises close to or in the posterior fascicle of the left bundle branch and shows a right bundle branch block (RBBB) morphology and left axis deviation. [1][2][3][4][5] Idiopathic left VT also arises from or close to the anterior fascicle of the left bundle and shows RBBB morphology and right axis deviation.6-9) Idiopathic left VT is responsive to verapamil but not adenosine. 5) Reentry is thought to be the operative mechanism of the tachycardia. There are sporadic case reports showing that some idiopathic left VT may be responsive to adenosine and that the operative mechanism may not be reentry. [10][11][12][13] Recent studies have demonstrated an epicardial origin in a specific subgroup of patients with idiopathic left ventricular outflow tract tachycardia.14,15) We report two cases of VT originating SUMMARY Ventricular tachycardia (VT) in coronary artery disease arises mostly from endocardial sites. However, little is known about the site of origin in other diseases. We report two patients who had VT originating from an anterior aspect of the left ventricle just below the mitral annulus, adjacent to the left ventricular outflow tract. The QRS configuration of VT showed an inferior axis and monophasic R waves in all the precordial leads. Radiofrequency current delivered to this site from the endocardial site successfully ablated the tachycardia in both. (Jpn Heart J 2000; 41: 215-225)

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Comparison of In Vivo Tissue Temperature Profile and Lesion Geometry for Radiofrequency Ablation With a Saline-Irrigated Electrode Versus Temperature Control in a Canine Thigh Muscle Preparation

Cited by 573 publications

References 29 publications

Saline-Cooled Versus Standard Radiofrequency Catheter Ablation for Infarct-Related Ventricular Tachycardias

Saline-Cooled Versus Standard Radiofrequency Catheter Ablation for Infarct-Related Ventricular Tachycardias

Characterization of Reentrant Circuits in Left Atrial Macroreentrant Tachycardia

Radiofrequency Catheter Ablation of Ventricular Tachycardia from the Anterobasal Left Ventricle.

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