Epicardial infrared ablation to create a linear conduction block on a beating right atrium

J Cardiothorac Surg. 2018 Nov 16;13(1):116. doi: 10.1186/s13019-018-0801-y.

Abstract

Background: It is still difficult to create a secure linear conduction block on a beating heart from the epicardial side. To overcome this drawback we developed an infrared coagulator equipped with a cuboid light-guiding quartz rod. This study was designed to electrophysiologically confirm the efficacy of a new ablation probe using infrared energy in a clinical case.

Methods: The infrared light from a lamp is focused into the newly developed cuboid quartz rod, which has a rectangular distal exit-plane that allows 30 mm × 10 mm linear photocoagulation. Two pairs of electrodes were attached to the right atrium of a patient who was undergoing surgery. Each pair of electrodes was placed 10 mm from an ablation line. The change in conduction time between the two pairs of electrodes was measured during ablation. The predicted conduction time delay ratio was 1.54.

Results: The actual conduction time after ablation was 1.38-1.43 times longer than the pre-ablation conduction time.

Conclusions: The infrared ablation using a newly developed cuboid probe made it possible to create a linear conduction block on the beating right atrial free wall clinically.

Keywords: Ablation; Arrhythmia treatment; Atrial fibrillation; Coagulator; Electrophysiology; Energy source; Infrared; Maze procedure; Minimally invasive surgery; Photocoagulation.

MeSH terms

  • Animals
  • Atrial Fibrillation / pathology
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery*
  • Catheter Ablation
  • Chickens
  • Electrodes
  • Heart Atria / pathology
  • Heart Atria / physiopathology
  • Heart Atria / radiation effects
  • Heart Atria / surgery*
  • Heart Conduction System / pathology
  • Heart Conduction System / physiopathology
  • Heart Conduction System / radiation effects
  • Heart Conduction System / surgery*
  • Humans
  • Infrared Rays / therapeutic use*
  • Models, Animal
  • Pericardium / pathology
  • Pericardium / physiopathology
  • Pericardium / radiation effects
  • Pericardium / surgery*