Details

Autor(en) / Beteiligte

• van Driel, Vincent J.H.M
• Neven, Kars G.E.J
• van Wessel, Harry
• du Pré, Bastiaan C
• Vink, Aryan
• Doevendans, Pieter A.F.M
• Wittkampf, Fred H.M

Titel

Pulmonary Vein Stenosis After Catheter Ablation: Electroporation Versus Radiofrequency

Ist Teil von

• Circulation. Arrhythmia and electrophysiology, 2014-08, Vol.7 (4), p.734-738

Ort / Verlag

United States: American Heart Association, Inc

Erscheinungsjahr

2014

Quelle

MEDLINE

Beschreibungen/Notizen

• BACKGROUND—Radiofrequency ablation inside pulmonary vein (PV) ostia can cause PV stenosis. A novel alternative method of ablation is irreversible electroporation, but the long-term response of PVs to electroporation ablation is unknown. METHODS AND RESULTS—In ten 6-month-old pigs (60–75 kg), the response of PVs to circular electroporation and radiofrequency ablation was compared. Ten consecutive, nonarcing, electroporation applications of 200 J were delivered 5 to 10 mm inside 1 of the 2 main PVs, using a custom-deflectable, 18-mm circular decapolar catheter. Inside the other PV, circular radiofrequency ablation was performed using 30 W radiofrequency applications via an irrigated 4-mm ablation catheter. PV angiograms were made before ablation, immediately after ablation, and after 3-month survival. PV diameters and heart size were measured. With electroporation ablation, PV ostial diameter decreased 11±10% directly after ablation, but had increased 19±11% after 3 months. With radiofrequency ablation, PV ostial diameter decreased 23±15% directly after ablation and remained 7±17% smaller after 3 months compared with preablation diameter despite a 21±7% increase in heart size during aging from 6 to 9 months. CONCLUSIONS—In this porcine model, multiple circumferential 200-J electroporation applications inside the PV ostia do not affect PV diameter at 3-month follow-up. Radiofrequency ablation inside PV ostia causes considerable PV stenosis directly after ablation, which persists after 3 months.