Experirnental Study of Catheter Ablation Using Ultrasound Energy in Canine and Porcine Hearts.

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概要

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• We examined the efficacy and safety of ultrasound energy in eliminating the arrhythmogenic substrates of atrial as well as ventricular tissue using a newly developed instrument in both in vivo and in vitro experiments. Ultrasound (US) applicators were tested on 79 lesions created on a beating heart in canine cardiac tissue, and on 64 lesions in porcine heart specimens. US lesions were created by using transducers with frequencies around 5-10MHz. In the in vivo study, we observed a significant decrease in the amplitude of the electrograms recorded from the tip of the ablation catheter during the US application (p<0.01). In some sites transmural lesions could be created which were well demarcated. Blood coagulum formation was observed on the tip of the ablation catheter on several occasions. In one dog ventricular fibrillation was provoked by the delivery of ultrasound energy to the left ventricle. In the in vitro study, lesion depth increased significantly with a longer duration of energy delivery when the temperature was maintained stable (p<0.001), and the lesion depth increased significantly with higher temperatures of energy delivery when the duration of US application was maintained (p<0.05). In both cases, no significant change in surface area was observed. The maximum depth of the lesion was 10.3mm. Conclusions: An ultrasound energy system is relatively safe and effective for creating lesions large enough to eliminate arrhythmogenic substrates deep in the ventricular myocardium. Although the US system is free from pop phenomenon, the problem of blood coagulation on the catheter tip remains to be settled.

著者

• Okishige Kaoru

  Cardiac Electrophysiology Laboratory Cardiovascular Department Yokohama Red Cross Hospital

• Hiejima Kazumasa

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

• OHKUBO Toyoyuki

  Second Department of Internal Medicine, Tokyo, Japan.

• Ibukiyama Chiharu

  Second Department Of Internal Medicine Tokyo Medical College

• MATSUBARA Tetsu

  Second Department of Internal Medicine, Tokyo Medical College, School of Medicine

• GOSEKI Yoshinari

  Second Department of Internal Medicine, Tokyo Medical College, School of Medicine

• IBUKIYAMA Chiharu

  Second Department of Internal Medicine, Tokyo Medical College, School of Medicine

• HIEJIMA Kazumasa

  Department of Health and Hygiene, Tokyo Medical and Dental University

• OKISHIGE Kaoru

  Cardiovascular Division, Yokohama Red Cross Hospital

• OHKUBO Toyoyuki

  Second Department of Internal Medicine, Tokyo Medical College, School of Medicine

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