title: The ABLA-BOX: An In Vitro Module of Hybrid Atrial Fibrillation Ablation.
abstract: OBJECTIVE
  We present the first testing study on the ABLA-BOX, a new in vitro module of hybrid atrial fibrillation ablation.
  
  
  METHODS
  ABLA-BOX consists of two chambers that mimic the epicardial and endocardial sides of the heart. The septum between chambers provides catheter access on both sites of the cardiac tissue. A circuit, filled with freshly obtained porcine blood, including a pump, an oxygenator, and a heating device, circulate the blood inside the system. Left atrial fresh tissue is mounted on a tissue holder and magnetically fixed. Epicardial and endocardial catheters are fixed on the catheter holders and blocked with the locker knob. The system allows control of ablation force, flow rate, temperature, and flow pattern.
  
  
  RESULTS
  Epicardial contact force of 100 g and endocardial force of 30 g resulted in larger lesion volumes (P < 0.001), areas (P < 0.001), and lesion diameters (P = 0.03 and P = 0.008), than the combination of 100/20 g. In addition, with a flow rate of 5 L/min, lesion volumes (P = 0.02), areas (P < 0.001), and diameters (both, P < 0.001) were significantly larger in comparison with those of 3 L/min. Furthermore, dimensions (both, P < 0.001), volume (P < 0.001), and area (P < 0.001) of the lesions at a circulating blood temperature of 38.0°C were larger than with a lower blood temperature (36.0°C). Finally, ablations made under stable flow pattern resulted in greater lesion diameters (P = 0.04 and P = 0.03) as well as larger volumes (P = 0.02) and areas (P = 0.03) than under turbulent-like flow reproduced with the system rotor set to 400 rpm.
  
  
  CONCLUSIONS
  The ABLA-BOX allowed easy hybrid ablation with different setups, which can provide cardiologists and cardiac surgeons with reliable and more valuable insights.
authors.affiliation: From the *Cardiology and Cardiothoracic Department, Maastricht University Medical Center, Maastricht, the Netherlands; †Department of Clinical and Experimental Medicine, Careggi University Hospital-University of Florence, Florence, Italy; and ‡Department of Cardiothoracic Surgery, University Hospital, Brussels, Belgium.
authors.forename: Pieter W J
authors.initials: PW
authors.lastname: Lozekoot
authors.forename: Monique M J
authors.initials: MM
authors.lastname: de Jong
authors.forename: Orlando
authors.initials: O
authors.lastname: Parise
authors.forename: Francesco
authors.initials: F
authors.lastname: Matteucci
authors.forename: Fabiana
authors.initials: F
authors.lastname: Lucà
authors.forename: Narendra
authors.initials: N
authors.lastname: Kumar
authors.forename: Daniele
authors.initials: D
authors.lastname: Bani
authors.forename: Jens
authors.initials: J
authors.lastname: Czapla
authors.forename: Laurent
authors.initials: L
authors.lastname: Pison
authors.forename: Harry J G M
authors.initials: HJ
authors.lastname: Crijns
authors.forename: Jos G
authors.initials: JG
authors.lastname: Maessen
authors.forename: Mark
authors.initials: M
authors.lastname: La Meir
authors.forename: Sandro
authors.initials: S
authors.lastname: Gelsomino
mesh_terms: D000818:Animals; D001281:Atrial Fibrillation / Q000601:surgery; D017115:Catheter Ablation / Q000295:instrumentation*; D004867:Equipment Design; D006329:Heart Conduction System / Q000503:physiopathology; D023421:Models, Animal; D013552:Swine