title: Irrigated Needle Ablation Creates Larger and More Transmural Ventricular Lesions Compared With Standard Unipolar Ablation in an Ovine Model.
abstract: BACKGROUND
  Ventricular tachycardia recurrence can occur after ventricular tachycardia ablation because of incomplete and nontransmural ventricular lesion formation. We sought to compare the lesions made by a novel irrigated needle catheter to conventional radiofrequency lesions.
  
  
  RESULTS
  Thirteen female sheep (4.6±0.7 years, 54±8 kg) were studied. In 7 sheep, 60-s radiofrequency applications were performed using an irrigated needle catheter. In 6 sheep, conventional lesions were made using a 4-mm irrigated catheter. 1.5T in vivo and high-density magnetic resonance imaging (9.4T) were performed on explanted hearts from animals receiving needle radiofrequency. Conventional lesion volume was calculated as (1/6)×π×(A×B(2)+C×D(2)/2). Needle lesion volume was measured as Σ(π×r(2))/2 with a slice thickness of 1 mm. The dimensions of all lesions were also measured on gross pathology. Additional histological analysis of the needle lesions was performed. One hundred twenty endocardial left ventricular ablation lesions (conventional, n=60; needle, n=60) were created. At necropsy, more lesions were found using needle versus conventional radiofrequency (90% versus 75%; P<0.05). Comparing needle versus conventional radiofrequency: lesion volume was larger (1030±362 versus 488±384 mm(3); P<0.001), lesion depth was increased (9.9±2.7 versus 5±2.4 mm; P<0.001), and more transmural lesions were created (62.5% versus 17%; P<0.01). Pericardial contrast injection was observed in 4 apical attempts using needle radiofrequency, however, with no adverse effects. Steam pops occurred in 3 attempts using conventional radiofrequency.
  
  
  CONCLUSIONS
  Irrigated needle ablation is associated with more frequent, larger, deeper, and more often transmural lesions compared with conventional irrigated ablation. This technology might be of value to treat intramural or epicardial ventricular tachycardia substrates resistant to conventional ablation.
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Benjamin
authors.initials: B
authors.lastname: Berte
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Hubert
authors.initials: H
authors.lastname: Cochet
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Julie
authors.initials: J
authors.lastname: Magat
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Jérôme
authors.initials: J
authors.lastname: Naulin
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Daniele
authors.initials: D
authors.lastname: Ghidoli
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Xavier
authors.initials: X
authors.lastname: Pillois
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Frédéric
authors.initials: F
authors.lastname: Casassus
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Seigo
authors.initials: S
authors.lastname: Yamashita
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Saagar
authors.initials: S
authors.lastname: Mahida
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Nicolas
authors.initials: N
authors.lastname: Derval
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Bruno
authors.initials: B
authors.lastname: Quesson
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Olivier
authors.initials: O
authors.lastname: Bernus
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Rukshen
authors.initials: R
authors.lastname: Weerasooriya
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.).
authors.forename: Frédéric
authors.initials: F
authors.lastname: Sacher
authors.affiliation: From the Department of Cardiology and Radiology, Hôpital Haut-l'évêque, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France (B.B., H.C., X.P., F.C., S.Y., S.M., N.D., M. Hocini, M. Haïssaguerre, F.S., P.J.); LIRYC Institute, Institut Hospitalo-Universitaire (IHU), Bordeaux, France (B.B., H.C., J.M., J.N., M. Hocini, B.Q., O.B., M. Haïssaguerre, F.S., P.J.); Biosense Webster, Research and Development Department, Palo Alto, CA (D.G.); and Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia (R.W.). pierre.jais@chu-bordeaux.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
mesh_terms: D000818:Animals; D001706:Biopsy; D062906:Cardiac Catheters; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004195:Disease Models, Animal; D022062:Electrophysiologic Techniques, Cardiac; D004867:Equipment Design; D005260:Female; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D009339:Needles; D012756:Sheep; D017180:Tachycardia, Ventricular / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D007507:Therapeutic Irrigation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D014693:Ventricular Fibrillation / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*
keywords: ablation techniques; arrhythmias, cardiac; catheter ablation; magnetic resonance imaging; model; s, animal