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  • 1
    Electronic Resource
    Electronic Resource
    Use of a Diode Laser Balloon Ablation Catheter to Generate Circumferential Pulmonary Venous Lesions in an Open-Thoracotomy Caprine Model (2004)
    350 Main Street , Malden , MA 02148-5018 , USA and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 27 (2004), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Electrical isolation of the pulmonary veins (PVs) can be curative in certain patients with atrial fibrillation. The ability of a diode laser balloon ablation catheter to isolate PVs was assessed in an open-thoracotomy caprine model system. After a median sternotomy, the left atrial appendage was cannulated in 19 goats. A laser balloon catheter was placed at the PV ostia and used to deliver photonic energy to the periostial tissue. The applications were delivered at 3.7, 4.5, or 5.4 W/cm for 90–150 seconds. Electrical continuity of the PV with the left atrium was assessed using a multielectrode mapping catheter. After a single application of photonic energy, electrical isolation of the PVs was achieved in (70%) 19/27 PVs. However, the success of electrical PV isolation did not correlate with the dose or duration of the applications. When reflectance spectroscopy was utilized to ensure adequate orientation and contact of the laser balloon catheter with the left atrial myocardium, complete PV isolation was achieved in 5/5 veins at 3.5 W/cm for 120 seconds. Pathological examination revealed no PV stenosis, no pericardial damage, minor lung lesions without pleural perforation, minimal endothelial disruption, and, in the presence of adequate heparinization, no endocardial charring or overlying thrombus. Effective isolation of the PVs can be achieved by delivery of a continuous circular beam of photonic energy to ablate the left atrial - pulmonary venous junction. The use of reflectance spectroscopy to provide real-time monitoring of the blanching effect of balloon-tissue contact optimizes lesion delivery. (PACE 2004; 27:52–57)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.2004.00385.x
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  • 2
    Electronic Resource
    Electronic Resource
    Pericardial Anatomy for the Interventional Electrophysiologist (2003)
    350 Main Street , Malden , MA 02148 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 14 (2003), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Investigators are beginning to exploit the pericardial space for a number of cardiovascular applications, including catheter ablation of cardiac arrhythmias, cardiovascular drug therapy, and cardiac pacing. This review explores the anatomy of the pericardial space and the anatomic variants that may be encountered in this novel approach to the heart. (J Cardiovasc Electrophysiol, Vol. 14, pp. 422-430, April 2003)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2003.02487.x
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  • 3
    Electronic Resource
    Electronic Resource
    Three-Dimensional Reconstruction of the Coronary Sinus Using Rotational Angiography (2005)
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 16 (2005), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2005.40752.x
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  • 4
    Electronic Resource
    Electronic Resource
    Catheter Ablation of Atrial Flutter after Orthotopic Heart Transplantation (2004)
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 15 (2004), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Introduction: Atrial arrhythmias, including atrial flutter, are common in orthotopic heart transplant recipients. However, only a small number of individual case reports describe the electrical circuit and catheter ablation of atrial flutter after heart transplantation. Methods and Results: Detailed electrophysiologic evaluation and radiofrequency ablation of atrial flutter were performed in three patients after orthotopic heart transplantation. All cases involved a counterclockwise flutter circuit around the tricuspid annulus. All were successfully ablated at the isthmus between the tricuspid valve and the atrial anastomosis adjacent to the inferior vena cava. Conclusion: Atrial flutter involving a counterclockwise circuit around the tricuspid annulus is common in the heart transplant population. Based on the patients described in this study and other cases reported in the literature, this arrhythmia often is treated successfully by ablation of the isthmus between the tricuspid valve and the atrial anastomosis near the inferior vena cava.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2004.04440.x
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  • 5
    Electronic Resource
    Electronic Resource
    Use of Electrogram Characteristics During Sinus Rhythm to Delineate the Endocardial Scar in a Porcine Model of Healed Myocardial Infarction (2003)
    350 Main Street , Malden , MA 02148 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 14 (2003), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Introduction: Substrate-based catheter ablation of postmyocardial infarction (post-MI) ventricular tachycardia necessitates electroanatomic definition of the scarred endocardium. We sought to determine whether electrogram criteria during sinus rhythm could identify the location and extent of the myocardial scar by electroanatomic mapping. Methods and Results: A porcine model of healed MI was generated by injecting agarose microspheres into the mid left anterior descending coronary artery. At least 4 weeks post-MI, the animals (n = 24) underwent detailed left ventricular endocardial electroanatomic mapping using a 4-mm-tip catheter (BioSense-Webster, Inc.). Based upon mapping data in normal animals, infarcted tissue was defined as bipolar electrogram amplitude 〈1.5 mV and electrogram duration ≥50 msec. Radiofrequency ablation lesions (2–10 per animal) were placed to tag the endocardial borders of the electroanatomic mapping-defined scar. The area of the scar defined by abnormal voltage amplitude was 25.9 ± 15.4 cm2 (range 6.9–60.5). This area correlated well with that defined as scar by the electrogram duration criteria (26.4 ± 16 cm2) . Of those points remote from the infarct with falsely low voltage amplitude resulting from presumed poor catheter-tissue contact, 94% were correctly identified as normal when using the electrogram duration criteria. Late potentials were observed predominantly along the borders of the infarcted myocardium. The radiofrequency lesions placed to tag the scar borders were located along the scar periphery during gross pathologic examination. Conclusion: During normal sinus rhythm, both bipolar electrogram voltage amplitude and electrogram duration criteria are able to help differentiate normal from scarred myocardial tissue. Using these criteria, a detailed reconstruction of the endocardial scar can be rendered by electroanatomic mapping of the heart. (J Cardiovasc Electrophysiol, Vol. 14, pp. 524-529, May 2003)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2003.02499.x
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  • 6
    Electronic Resource
    Electronic Resource
    Extra-Ostial Pulmonary Venous Isolation: (2003)
    350 Main Street , Malden , MA 02148 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 14 (2003), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: During catheter ablation of atrial fibrillation, ablation within the pulmonary veins is undesirable due to the risk of pulmonary venous stenosis and the possibility of leaving residual cuffs of arrhythmogenic tissue proximal to the ablation lesion set. An extra-ostial pulmonary vein isolation strategy may circumvent these limitations, but achieving electrical isolation can be technically challenging, even with the use of saline-irrigated radiofrequency energy technology. This report describes the successful use of epicardial radiofrequency ablation in a patient in whom endocardial irrigated radiofrequency ablation failed to achieve extra-ostial pulmonary vein isolation. (J Cardiovasc Electrophysiol, Vol. 14, pp. 663-666, June 2003)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2003.03049.x
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