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Protection of the Coronary Arteries During Epicardial Radiofrequency Ablation with Intracoronary Chilled Saline Irrigation: Assessment in an In Vitro Model
Author(s) -
THYER ISAAC A.,
KOVOOR PRAMESH,
BARRY MICHAEL A.,
POULIOPOULOS JIM,
ROSS DAVID L.,
THIAGALINGAM ARAVINDA
Publication year - 2006
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2006.00417.x
Subject(s) - medicine , ablation , saline , coronary arteries , cardiology , artery , radiofrequency ablation , catheter ablation , catheter , right coronary artery , interquartile range , lumen (anatomy) , surgery , coronary angiography , myocardial infarction
The coronary arteries can be damaged during epicardial radiofrequency ablation (RFA) procedures. We hypothesized that intracoronary irrigation with chilled saline may be a useful technique for minimizing heat‐induced damage to the coronary artery endothelium during this procedure. Methods and Results: Twenty‐nine ablation procedures were performed on 17 freshly excised ovine hearts. Radiofrequency current was delivered through an internally cooled, 4‐mm‐tip ablation catheter placed directly over the coronary artery (24 applications) and over noncoronary epicardium (5 applications). An Amplatz coronary catheter was used to internally irrigate the coronary artery with either 37°C or 5°C 0.9% saline (12 ablations each group). Fluroptic temperature probes were placed within the artery lumen under the ablation site and 15 mm distal from the ablation site. The peak intracoronary temperature directly under the ablation catheter was significantly lower (P = 0.001) in the chilled than in the nonchilled saline irrigation group (23.6°C, interquartile range [IQR] 15.7–39.8 vs 54.6°C, IQR 48.9–58.6). Blue tetrazolium stained lesion sections showed that the median distance between the ablation lesion and the artery wall was significantly higher (P = 0.004) for the chilled versus the nonchilled saline irrigation group (0.42 mm, IQR 0.25–0.70 vs 0.00 mm, IQR 0.00–0.28). Conclusions: Intracoronary irrigation with chilled saline may protect the coronary artery endothelium from heat‐induced damage during epicardial RFA.