Effects of corticosteroid therapy on the long-term outcome of radiofrequency lesions in the Swine caval veins.
BACKGROUND
We explored the angiographic and pathological effects of corticosteroids on the long-term outcome of radiofrequency (RF) ablation lesions in the swine caval veins.


METHODS
Under fluoroscopy guidance, a single linear RF lesion (4-mm tip, 60 degrees C, 180 seconds) was created in each vena cava (from +/-2 cm into the vein to the venoatrial junction) of 20 anesthetized minipigs (35+/- 2 kg). Three groups were studied: acute (n = 4), killed 1 hour after RF; control (n = 8), sacrificed 83+/- 1 days after RF; and pigs (n = 8) receiving hydrocortisone (400 mg i.v. after RF) and prednisone (25 mg po for 30 days), killed 83+/- 1 days post-RF. Angiography was performed before, immediately after ablation, and at follow-up. Then, animals were sacrificed for histological analysis.


RESULTS
Mild (<40%) or moderate (41-70%) acute luminal narrowing occurred in 19/20 (95%) inferior veins and in 13/20 (65%) superior veins. Severe (>70%) stenosis and occlusions were not noted. At follow-up, in both chronic groups, mean vessel diameters returned to baseline and progression of luminal narrowing did not occur in any vein. Of note, superior and inferior vena cava angiographic diameter for control and treated pigs did not differ. The same was observed for the cross-sectional luminal area. Acute lesions displayed transmural coagulative necrosis whereas chronic lesions revealed marked fibrosis. Histological findings were similar in controls and treated pigs.


CONCLUSIONS
In this model, mild and moderate stenosis, occurring immediately after ablation, seems to resolve over time. Corticosteroids do not affect the long-term outcome of such RF lesions in the caval veins.
Fenelon
Guilherme
G
Department of Cardiology, Paulista School of Medicine, Federal University of São Paulo, Brazil. guilhermefenelon@uol.com.br
Nascimento
Thais
T
DE Araújo
Sérgio
S
Okada
Mieko
M
Franco
Marcello
M
DE Paola
Angelo A V
AA
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000818:Animals; D001145:Arrhythmias, Cardiac / Q000188:drug therapy*; D017115:Catheter Ablation; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects* / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D013552:Swine; D013556:Swine, Miniature; D016896:Treatment Outcome; D014684:Venae Cavae / Q000601:surgery*
D000305:Adrenal Cortex Hormones