Ex vivo efficacy assessment of ultralow temperature cryoablation versus standard RF ablation applied to surgical ventricular patches: implications for ventricular ablation in patients with repaired congenital heart disease.

IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Tom J R De Potter, Dimitri Buytaert, Chiara Valeriano, Lucio Addeo, Alex Babkin, Joris Ector
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引用次数: 0

Abstract

Background: Clinical experience during trans-patch ventricular ablations shows difficult lesion formation when using standard RF ablation technology. The aim of this exploratory study is to test if ultralow temperature cryoblation (ULTC) technology could be suitable for trans-patch ventricular ablations.

Materials and methods: Ex vivo ablations were performed on 16 porcine tenderloin specimens of 5 × 7 × 3 cm, eight with and eight without pericardial patch (Supple Peri-Guard Repair Patch, Baxter, USA). RF energy was applied for 1 min, with a power of 40W. ULTC was applied as a 2 × 2 min freeze. Temperature was measured using an array of thermocouples ranging between 0.5 and 13.1 mm below the tissue surface.

Results: For RF, the maximum temperatures without and with patch respectively reached 58.9 °C and 48.5 °C. The thermocouple closest to the tissue surface displayed a 41% temperature range drop when RF energy was applied trans-patch, whereas the same thermocouple showed a 16% and 13% drop for the first and second ULTC freeze cycle when ULTC was applied trans-patch. The 45 °C isotherm depth was reduced by 55% for RF ablations, whereas the - 25 °C isotherm depth was reduced by 23% and 19% for the first and second freeze cycles, respectively.

Conclusion: Both energy modalities show reduced efficacy for trans-patch ablations when considering absolute temperature differences and estimated lesion depths. However, when considering relative differences, ULTC is more effective than RF for trans-patch lesions. Additionally, ULTC did not show visible damage to either the patch or the ex vivo specimen, while RF resulted in visible damage to both the tissue and patch.

超低温冷冻消融与标准射频消融应用于外科心室贴片的体外疗效评估:对修复先天性心脏病患者心室消融的影响
背景:经膜片心室消融的临床经验表明,使用标准射频消融技术很难形成病变。本探索性研究的目的是测试超低温冷冻消融(ULTC)技术是否适用于经膜片心室消融。材料与方法:对16例5 × 7 × 3 cm的猪里腰肉标本进行离体烧结术,8例有心包贴片,8例无心包贴片(美国Baxter公司的Supple perii - guard Repair patch)。射频能量施加1分钟,功率为40W。ULTC冷冻时间为2 × 2 min。温度测量使用热电偶阵列在0.5和13.1毫米之间的组织表面。结果:RF无贴片和贴片的最高温度分别为58.9°C和48.5°C。当应用射频能量时,最靠近组织表面的热电偶显示出41%的温度范围下降,而当应用ULTC时,同一热电偶在第一次和第二次ULTC冻结循环中显示出16%和13%的下降。RF消融45°C等温线深度减少了55%,而- 25°C等温线深度在第一次和第二次冷冻循环中分别减少了23%和19%。结论:当考虑到绝对温差和估计的病变深度时,两种能量模式对跨片消融的疗效都有所降低。然而,当考虑到相对差异时,ULTC比RF对跨斑块病变更有效。此外,ULTC对贴片或离体标本均无明显损伤,而RF对组织和贴片均有明显损伤。
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来源期刊
CiteScore
4.30
自引率
11.10%
发文量
320
审稿时长
4-8 weeks
期刊介绍: The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.
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