Radiofrequency catheter ablation guided by intracardiac echocardiography.

Chu, Edward; Fitzpatrick, Adam P.; Chin, Michael C.; Sudhir, Krishnankutty; Yock, Paul G.; Lesh, Michael D.

doi:10.1161/01.cir.89.3.1301

Cited by 126 publications

(61 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…19,20 In animals subjected to radiofrequency catheter ablation, the lesion size noted with intracardiac ultrasound correlates well with the lesion size observed postmortem. 20 In the present study, diagnostic ultrasound was used to select ablation target sites and to monitor …”

Section: Imaging Of Ablation Targets and Lesionssupporting

confidence: 54%

Extracardiac Ablation of the Canine Atrioventricular Junction by Use of High-Intensity Focused Ultrasound

et al. 1999

View full text Add to dashboard Cite

Background-High-intensity focused ultrasound has been applied to internal organs from outside the body to ablate tissue.No published study has assessed the feasibility of ablating cardiac tissue within the beating heart by use of this type of therapeutic ultrasound. The purpose of this study was to determine whether high-intensity focused ultrasound can be used to ablate the atrioventricular (AV) junction within the beating heart. Methods and Results-Ten dogs were anesthetized and underwent a thoracotomy. The heart was covered with a polyvinyl chloride membrane. The thorax above the membrane was perfused with degassed water, which functioned as a coupling medium for the ultrasound. A 7.0-MHz diagnostic ultrasound probe was affixed to a spherically focused 1.4-MHz high-intensity focused ultrasound transducer with a 1.1ϫ8.3-mm focal zone 63.5 mm from the ablation transducer. The diagnostic ultrasound probe was calibrated such that the location of the focal zone of the ablation transducer was identifiable on the 2-dimensional ultrasound image. Target sites were identified with the diagnostic ultrasound. The maximum ultrasound intensity for ablation (2.8 kW/cm 2 ) was delivered to the AV junction only during electrical diastole and for a total of 30 seconds. Complete AV block was achieved in each of the 10 dogs with 6.5Ϯ5.6 (range, 3 to 21) 30-second applications of therapeutic ultrasound. Gross inspection showed that the mean lesion volume was 124Ϯ143 mm 3 , with a depth of 6.7Ϯ3.6 mm, a length of 5.7Ϯ2.5 mm, and a width of 4.7Ϯ1.8 mm. Four hours after the dogs were killed, histopathological study demonstrated a well-demarcated area of necrosis and early inflammation. Conclusions-High-intensity focused ultrasound produces well-demarcated lesions and appears to be a feasible energy source to create complete AV block within the beating heart without damaging the overlying or underlying cardiac tissue. This energy source may allow for a noninvasive approach to ablation of cardiac arrhythmias. (Circulation. 1999;100:203-208.)

show abstract

Section: Imaging Of Ablation Targets and Lesionssupporting

confidence: 54%

Extracardiac Ablation of the Canine Atrioventricular Junction by Use of High-Intensity Focused Ultrasound

et al. 1999

View full text Add to dashboard Cite

show abstract

“…Several studies have demonstrated the utility of intracardiac ultrasound for guiding cardiac ablation therapy [11][12][13] and visualizing thermal lesions in vitro. 10,14 A recent study by Epstein and colleagues 15 compared intracardiac ultrasound to fluoroscopy guidance for creating linear right atrial lesions in a canine model and showed that intracardiac ultrasound significantly improved targeting, energy delivery, and lesion formation.…”

Section: Comparison With Other Imaging Modalitiesmentioning

confidence: 99%

Visualization and Temporal/Spatial Characterization of Cardiac Radiofrequency Ablation Lesions Using Magnetic Resonance Imaging

et al. 2000

View full text Add to dashboard Cite

Background-The purpose of this study was to describe a system and method for creating, visualizing, and monitoring cardiac radiofrequency ablation (RFA) therapy during magnetic resonance imaging (MRI). Methods and Results-RFA was performed in the right ventricular apex of 6 healthy mongrel dogs with a custom 7F nonmagnetic ablation catheter (4-mm electrode) in a newly developed real-time interactive cardiac MRI system. Catheters were positioned to intracardiac targets by use of an MRI fluoroscopy sequence, and ablated tissue was imaged with T2-weighted fast spin-echo and contrast-enhanced T1-weighted gradient-echo sequences. Lesion size by MRI was determined and compared with measurements at gross and histopathological examination. Ablated areas of myocardium appeared as hyperintense regions directly adjacent to the catheter tip and could be detected 2 minutes after RF delivery. Lesions reached maximum size Ϸ5 minutes after ablation, whereas lesion signal intensity increased linearly with time but then reached a plateau at 12.

show abstract

“…It usually occurs at the site with the highest temperature (the surface of the heated tissue) and has poor adherence to the ablation electrode and transeptal sheaths. 8 Such a formation may only be noticeable with intracardiac echocardiography (ICE), because it may not be associated with impedance rises 9, and occurs even in patients submitted to increased intensity anticoagulation protocols. [10][11][12] Some studies have shown that more aggressive heparinization strategies during the procedure results in a reduction of embolic complications.…”

Section: Soft Thrombus Formationmentioning

confidence: 99%

Periablative Anticoagulation Strategies in Patients with Atrial Fibrillation

Saad¹,

Ferreira²

2008

J.A.F.I.B

View full text Add to dashboard Cite

Atrial fibrillation is associated with thromboembolic events that may cause important impairment on quality of life. Pulmonary vein isolation is the treatment of choice in cases that are refractory to medical therapy. Once sheaths and catheters are manipulated inside the left atrium, anticoagulation with heparin must be used during the procedure to protect patients from thromboembolic phenomena. Different strategies of anticoagulation are used at different centers. This review summarizes the pathophysiology of thrombus formation in the left atrium, defines which patients are under high risk and describes the main strategies used for anticoagulation

show abstract

Radiofrequency catheter ablation guided by intracardiac echocardiography.

Cited by 126 publications

References 14 publications

Extracardiac Ablation of the Canine Atrioventricular Junction by Use of High-Intensity Focused Ultrasound

Extracardiac Ablation of the Canine Atrioventricular Junction by Use of High-Intensity Focused Ultrasound

Visualization and Temporal/Spatial Characterization of Cardiac Radiofrequency Ablation Lesions Using Magnetic Resonance Imaging

Periablative Anticoagulation Strategies in Patients with Atrial Fibrillation

Contact Info

Product

Resources

About