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Deep Myocardial Ablation Lesions Can Be Created with a Retractable Needle‐Tipped Catheter
Author(s) -
SAPP JOHN LEWIS,
COOPER JOSHUA MORREY,
SOEJIMA KYOKO,
SORRELL TIMOTHY,
LOPERA GUSTAVO,
SATTI SRINIVASA DINAKAR,
KOPLAN BRUCE ANDREW,
EPSTEIN LAURENCE MARK,
EDELMAN ELAZER,
ROGERS CAMPBELL,
STEVENSON WILLIAM GREGORY
Publication year - 2004
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2004.00492.x
Subject(s) - medicine , endocardium , ablation , catheter , catheter ablation , ventricle , ventricular tachycardia , lesion , nuclear medicine , radiology , cardiology , surgery
RF catheter ablation of ventricular tachycardia is sometimes limited by inadequate lesion depth. This study investigated the use of a retractable needle‐tipped catheter to create deep RF lesions in vivo in porcine myocardium. An 8 Fr electrode catheter with an extendable 27‐gauge needle at the tip was modified for RF ablation by embedding a thermocouple and attaching a pin connector. In three swine (32–58 kg) the left ventricle was entered via the femoral artery and endocardial contact was made. The needle was advanced 10 mm and 13 RF applications were made under a controlled temperature (90°C × 120 s). Nine control lesions were made using a standard 4‐mm tip catheter (60°C × 120 s). The lesions were fixed, serially sectioned from the endocardium, digitally imaged, and quantified. Needle ablation lesions were deeper (10.15 ± 0.77 vs 5.67 ± 0.37 mm, P < 0.001) and more likely to be transmural (77 vs 11%, P = 0.008) than control lesions. The volume of control lesions, however, was larger (358.4 ± 56.2 vs 174.7 ± 18.6 mm 3 , P = 0.002) due to a significantly larger cross‐sectional area at the endocardium (0.548 ± 0.04 vs 0.151 ± 0.01 cm 2 , P < 0.001). At depths > 6 mm, the needle electrode lesions had a greater cross‐sectional area (0.136 ± 0.01 vs 0.005 ± 0.004 cm 2 , P < 0.001). Catheter‐based needle ablation is feasible and allows creation of deeper lesions that can be transmural. Although deep, the lesions had a small cross‐sectional area such that precise targeting would be required for success. (PACE 2004; 27:594–599)