Feasibility of electroporation for the creation of pulmonary vein ostial lesions.
BACKGROUND
There is an obvious need for a better energy source for pulmonary vein (PV) antrum isolation.


OBJECTIVE
We investigated the feasibility and safety of electroporation for the creation of PV ostial lesions.


METHODS
After transseptal puncture, a custom 7F decapolar 20 mm circular ablation catheter was placed in the PV ostia of 10 pigs. Ablation was performed with a nonarcing, 200 J application delivered between the catheter and an indifferent patch electrode on the lower back. A single pulse was applied for each catheter position, with a maximum of 4 per ostium. Local PV electrogram amplitude and stimulation threshold were measured at multiple locations in both ostia before and directly after ablation, and after 3 weeks survival, using a regular 4 mm mapping catheter. All PV ostia were sectioned, stained, and histologically investigated.


RESULTS
The 3-week survival period was uneventful. PV ostial electrogram amplitude decreased and stimulation threshold increased significantly in most ostia. PV angiograms did not show any stenosis during this short follow-up. Histologically, up to 3.5-mm-deep lesions were found.


CONCLUSIONS
Data suggest that electroporation can safely be used to create lesions in a sensitive environment like PV ostia.
Wittkampf
Fred H
FH
Division of Heart and Lungs, Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands. fredwittkampf@gmail.com
van Driel
Vincent J
VJ
van Wessel
Harry
H
Vink
Aryan
A
Hof
Irene E
IE
Gründeman
Paul F
PF
Hauer
Richard N W
RN
Loh
Peter
P
D000704:Analysis of Variance; D000818:Animals; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D057785:Catheters; D022062:Electrophysiologic Techniques, Cardiac; D018274:Electroporation / Q000295:instrumentation; D004867:Equipment Design; D005240:Feasibility Studies; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D011859:Radiography; D013552:Swine; D013997:Time Factors