Feasibility of electroporation for the creation of pulmonary vein ostial lesions

J Cardiovasc Electrophysiol. 2011 Mar;22(3):302-9. doi: 10.1111/j.1540-8167.2010.01863.x.

Abstract

Introduction: There is an obvious need for a better energy source for pulmonary vein (PV) antrum isolation.

Objective: We investigated the feasibility and safety of electroporation for the creation of PV ostial lesions.

Methods: After transseptal puncture, a custom 7F decapolar 20 mm circular ablation catheter was placed in the PV ostia of 10 pigs. Ablation was performed with a nonarcing, 200 J application delivered between the catheter and an indifferent patch electrode on the lower back. A single pulse was applied for each catheter position, with a maximum of 4 per ostium. Local PV electrogram amplitude and stimulation threshold were measured at multiple locations in both ostia before and directly after ablation, and after 3 weeks survival, using a regular 4 mm mapping catheter. All PV ostia were sectioned, stained, and histologically investigated.

Results: The 3-week survival period was uneventful. PV ostial electrogram amplitude decreased and stimulation threshold increased significantly in most ostia. PV angiograms did not show any stenosis during this short follow-up. Histologically, up to 3.5-mm-deep lesions were found.

Conclusion: Data suggest that electroporation can safely be used to create lesions in a sensitive environment like PV ostia.

MeSH terms

  • Analysis of Variance
  • Animals
  • Catheter Ablation / adverse effects
  • Catheter Ablation / instrumentation
  • Catheter Ablation / methods*
  • Catheters
  • Electrophysiologic Techniques, Cardiac
  • Electroporation* / instrumentation
  • Equipment Design
  • Feasibility Studies
  • Pulmonary Veins / diagnostic imaging
  • Pulmonary Veins / pathology
  • Pulmonary Veins / physiopathology
  • Pulmonary Veins / surgery*
  • Radiography
  • Swine
  • Time Factors