title: Laser photoablation of experimental post-infarction ventricular tachycardia guided by three dimensional activation mapping.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of epicardially delivered laser energy to ablate induced ventricular tachycardia in a post-infarction canine model.
  
  
  METHODS
  In 13 canines, the left anterior wall myocardial infarction was created. Five days later, 240 plunged electrodes were inserted into the heart. Three-dimensional ventricular activation sequences were analyzed on line by a computerized mapping system.
  
  
  RESULTS
  Sixteen sustained monomorphic ventricular tachycardias were reproducibly induced in 10 canines. Epicardially contacted Nd:YAG laser irradiated the areas of the final pathway in macro-reentrant activation and the impulse origin in focal excitation. Linear photocoagulation lesions (11-16 x 50-72 mm) were created. Seven macro-reentrant circuits and six of nine focal origins were eliminated (success rate 81%). Pathology showed that laser photocoagulation involved all surviving subepicardial and intramural fibers.
  
  
  CONCLUSIONS
  Epicardially delivered laser energy in conjunction with electrical activation mapping has a high probability of ablating post-infarction ventricular tachycardia.
authors.affiliation: Laser and Applied Technologies Laboratory, Carolinas Medical Center, Charlotte, North Carolina 28232, USA.
authors.forename: G
authors.initials: G
authors.lastname: Wu
authors.forename: R H
authors.initials: RH
authors.lastname: Svenson
authors.forename: L
authors.initials: L
authors.lastname: Littmann
authors.forename: C H
authors.initials: CH
authors.lastname: Chuang
authors.forename: M
authors.initials: M
authors.lastname: Thompson
authors.forename: G A
authors.initials: GA
authors.lastname: Nanney
authors.forename: R
authors.initials: R
authors.lastname: Splinter
authors.forename: G P
authors.initials: GP
authors.lastname: Tatsis
authors.forename: K R
authors.initials: KR
authors.lastname: Dezern
mesh_terms: D000818:Animals; D004285:Dogs; D004553:Electric Conductivity; D004562:Electrocardiography; D005260:Female; D006346:Heart Septum / Q000473:pathology; D017075:Laser Coagulation; D008297:Male; D009203:Myocardial Infarction / Q000150:complications*; D017180:Tachycardia, Ventricular / Q000473:pathology / Q000601:surgery*