THE RESPONSE OF ATRIOVENTRICULAR JUNCTIONAL TISSUE TO TEMPERATURE

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概要

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• To determine the optimal temperature for catheter heat mapping without damaging cardiac tissue, we studied the electrophysiologic and histologic responses of the atrioventricular (AV) conduction system exposed to a specific range of temperatures. In 18 closed-chest dogs, an electrode catheter with a thermistor, tip was positioned transvenously at the AV junction. Radiofrequency current (RFC) was applied in incremental temperature steps until transient 2nd-degree AV block was induced. Catheter tip temperature (CTT) was measured at each step. RFC was immediately discontinued when AV block occurred. AV conduction was evaluated before and 4 weeks after the procedure. Acute transient 2nd-degree AV block was induced in 45 applications, during which the average CTT was 48.7±2.7℃. In another 40 applications in which 2nd degree AV block was not induced, the average CTT was significantly lower [46.3±2.5℃] (p<0.001). Eleven of 16 dogs showed acute 2nd-degree AV block, but had normal AV conduction at 4 weeks (Group A). In the other 5 dogs, 1st-degree AV block was seen at 4 weeks (Group B). The lowest CTTs in Groups A and B were 45 and 49℃, respectively. Histologic findings in 2 dogs from Group A revealed that 10-15% (by area) of the AV node was fibrotic. These findings suggest that the induction of fully reversible AV block can be achieved by titration of RFC, during the application of RFC to the AV junction. In conclusion, RF energy was used to produce a tip temperature of between 45℃ and 49℃, which induced reversible and significant interruption of conduction of in tissue in the AV junction, and presumably also in target sites in clinical RF ablation.

• 社団法人日本循環器学会の論文
• 1994-04-20

著者

• Otomo Kenichiro

  Cardiovascular Department, Ohme Municipal General Hospital

• Kawara Tokuhiro

  Department of Biofunctional Informatics, Graduate School of Health Care Sciences, Tokyo Medical and

• Suzuki Fumio

  Fukujuji Hospital

• Hirao Kenzo

  First Department of Internal Medicine

• Suzuki Fumio

  First Department of Internal Medicine

• Hiejima Kazumasa

  Department of Allied Health Sciences, and School of Medicine, Tokyo Medical and Dental University

• Nawata Hiroko

  First Department of Internal Medicine, School of Medicine, Tokyo Medical and Dental University

• Suzuki Fumio

  Department Of Cardiovascular Medecine Tokyo Medical And Dental University

• Hiejima Kazumasa

  Department Of Allied Health Sciences And School Of Medicine Tokyo Medical And Dental University

• Kawara Tokuhiro

  Department Of Allied Health Sciences Tokyo Medical And Dental University School Of Medicine

• Tanaka Michio

  Department of Pathology, Tokyo Metropolitan Hiroo Generai Hospital

• SATO TADASHI

  First Department of Internal Medicine, Tokyo Medical and Dental University

• OTOMO KENICHIRO

  First Department of Internal Medicine, Tokyo Medical and Dental University

• YAMAMOTO NAOTO

  First Department of Internal Medicine, Tokyo Medical and Dental University

• NAWARA HIROKO

  First Department of Internal Medicine, Tokyo Medical and Dental University

• DOSHIDA NOBUO

  First Department of Internal Medicine, Tokyo Medical and Dental University

• Yamamoto Naohito

  Department of Cardiology, Soka City Hospital

• Otomo Kenichiro

  Cardiovascular Department Ohme Municipal General Hospital

• Nawata Hiroko

  First Department Of Internal Medicine School Of Medicine Tokyo Medical And Dental University

• Satoh Tsunehisa

  The 1st Dept. of Internal Medicine

• Sato Tadashi

  First Department Of Internal Medicine Tokyo Medical And Dental University

• Yamamoto Naohito

  Department Of Cardiology Soka City Hospital

• Suzuki Fumio

  Mitsubishi Electric Corporation

• Suzuki Fumio

  Department Of Regulatory Radiobiology Research Institute For Radiation Biology And Medicine Hiroshim

• Hirao Kenzo

  1st Dept. Of Internal Medicine Tokyo Medical And Dental University

• Hirao Kenzo

  Division Of Cardiology Heart Institute Chiba-nishi General Hospital

• Hiejima Kazumasa

  School Of Allied Health Science Tokyo Medical And Dental University

• Otomo Kenichiro

  First Department Of Internal Medicine Tokyo Medical And Dental University

• Doshida Nobuo

  First Department Of Internal Medicine Tokyo Medical And Dental University

• Hirao Kenzo

  東京医科歯科大学 第1内科

• Ohtomo Kenichiro

  Cardiovascular Department Ohme Municipal General Hospital

• Hirao Kenzo

  Department Of Cardiology Tokyo Medical And Dental University

• Suzuki Fumio

  Division Of Cardiology Kawaguchi Kohgyo General Hospital

• Tanaka Michio

  Department Of Pathology Tokyo Metropolitan Hiroo Generai Hospital

• Tanaka Michio

  Department Of Endoscopy Toyama Medical And Pharmaceutical University

• Suzuki Fumio

  Tokyo Med. And Dental Univ.

• TANAKA Michio

  Department of Clinical Laboratory, Tokyo Metropolitan Hiroo General Hospital

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