A new instrument of suction support adapter system for epicardial radiofrequency ablation.
OBJECTIVE
Recently, epicardial ablation on a beating heart has been conducted as a minimally invasive surgical procedure for atrial fibrillation. We have developed a suction support adapter with the aim of ensuring contact between the ablation probe and the atrial wall to obtain transmural coagulation, and we evaluated the effectiveness of the adapter in electrophysiologic and histopathologic procedures.


METHODS
To ensure contact between the radiofrequency ablation probe and the atrial wall, we designed and fabricated a suction support adapter. Twelve pigs were used in this study. A comparison was made between a group in which the ablation probe alone was used (group C, n = 6) and a group in which the ablation probe was used with the adapter (group S, n = 6). In both groups, epicardial ablation was conducted on a beating heart. An electrophysiologic evaluation was conducted to determine whether there was electrical isolation. Histopathologic evaluations were performed to identify the range of coagulation in the resected atrial wall specimens.


RESULTS
The coagulation range was significantly deeper in group S than in group C, and the breadth was significantly narrower. Transmural coagulation and electrical isolation of the atrial wall were seen in 1 case in group C and in all cases in group S.


CONCLUSIONS
Using the suction support adapter, we were able to maintain good contact between the ablation probe and the atrial wall. This device is thus thought to be useful for the safe and reliable performance of epicardial ablation on a beating heart.
Kadoya
Shinichi
S
Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine, Kanazawa, Ishikawa 920-0861, Japan. s-kadoya@ja2.so-net.ne.jp
Watanabe
Go
G
Koshida
Yoshinao
Y
Oda
Makoto
M
Yamaguchi
Shojiro
S
D000818:Animals; D017115:Catheter Ablation / Q000295:instrumentation*; D004867:Equipment Design; D010496:Pericardium / Q000601:surgery*; D013396:Suction / Q000295:instrumentation; D013552:Swine