Dose response curves for microwave ablation in the cardioplegia-arrested porcine heart.
BACKGROUND
Microwave ablation has been used clinically for the surgical treatment of atrial fibrillation, particularly during valve procedures. However, dose- response curves have not been established for this surgical environment. The purpose of this study was to examine dosimetry curves for the Flex 4 and Flex 10 microwave devices in an acute cardioplegia-arrested porcine model.


METHODS
Twelve domestic pigs (40-45 kg) were acutely subjected to Flex 4 (n = 6) and Flex 10 (n = 6) ablations. On a cardioplegically arrested heart maintained at 10-15(o)C, six endocardial atrial and seven epicardial ventricular lesions were created in each animal. Ablations were performed for 15 s, 30 s, 45 s, 60 s, 90 s, 120 s, and 150 s (65 W, 2.45 GHz). The tissue was stained with 2,3,5-triphenyl-tetrazolium chloride and lesions were sectioned at 5 mm intervals. Lesion depth and width were determined from digital photomicrographs of each lesion (resolution +/- .03 mm).


RESULTS
Average atrial thickness was 2.88 +/- .4 mm (range 1.0 to 8.0 mm). 94% of ablated atrial sections created by the FLEX 4 (n = 16) and the FLEX 10 (n = 16) were transmural at 45 seconds. 100% of atrial sections were transmural at 90 seconds with the FLEX 10 (n = 14) and at 60 seconds with the Flex 4 device (n = 15). Lesion width and depth increased with duration of application.


CONCLUSIONS
Both devices were capable of producing transmural lesions on the cardioplegically arrested heart at 65 W. These curves will allow surgeons to ensure transmural ablation by tailoring energy delivery to the specific atrial geometry.
Gaynor
Sydney L
SL
Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Byrd
Gregory D
GD
Diodato
Michael D
MD
Ishii
Yosuke
Y
Lee
Anson M
AM
Prasad
Sandip M
SM
Gopal
Jegan
J
Berube
Dany
D
Schuessler
Richard B
RB
Damiano
Ralph J
RJ
D000818:Animals; D004307:Dose-Response Relationship, Radiation; D004867:Equipment Design; D006323:Heart Arrest / Q000209:etiology* / Q000532:radiotherapy*; D006324:Heart Arrest, Induced; D006325:Heart Atria / Q000528:radiation effects; D008872:Microwaves / Q000627:therapeutic use*; D011878:Radiotherapy / Q000295:instrumentation; D013552:Swine