Development of a novel ablation hood to prevent systemic embolization of microbubbles and particulate emboli

J Interv Card Electrophysiol. 2020 Sep;58(3):281-288. doi: 10.1007/s10840-019-00595-y. Epub 2019 Aug 2.


Background: Atrial fibrillation ablation results in microbubbles and particulate emboli formation. We aimed to develop and test the early feasibility of a novel ablation hood to contain microbubbles and particulate emboli with the ultimate goal of preventing systemic embolization.

Methods: In seven canines, we developed, iterated, and tested a novel retractable hood that can cover the catheter-tissue ablation site. The number and volume (nL) of microbubbles formed during ablation with and without the hood was measured using an extracorporeal circulation loop. Wilcoxon's signed-rank test was used to compare the number of bubbles detected with and without the hood.

Results: The hood reduced systemic embolization of microbubbles in 21/28 (75%) of ablations. Both atrial and ventricular ablations showed a statistically significant reduction in bubble number (476 ± 811 without hood vs 173 ± 226 with hood, p = 0.02; 2669 ± 1623 without hood vs 1417 ± 970 with hood, p = 0.04, respectively) and bubble volume (3.3 ± 7.6 nL without hood vs 0.2 ± 0.56 nL with hood, p = 0.006; 6.1 ± 5.2 nL without hood vs 1.9 ± 1.4 nL with hood, p = 0.05, respectively).

Conclusions: Use of a novel hood to cover the ablation catheter at the site of catheter-tissue contact has the potential to provide a means to reduce systematic embolization of microbubbles. Further work is required to examine particulate emboli, but these data show the early feasibility of this design concept.

Keywords: Ablation; Innovation; Microbubbles; Systemic embolization.

MeSH terms

  • Animals
  • Atrial Fibrillation* / surgery
  • Catheter Ablation*
  • Dogs
  • Heart Atria / diagnostic imaging
  • Heart Atria / surgery
  • Microbubbles