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.

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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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