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首页> 外文期刊>IEEE Engineering in Medicine and Biology Magazine >Isthmus ablation with a novel microwave catheter in dogs
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Isthmus ablation with a novel microwave catheter in dogs

机译：用新型微波导管对犬进行峡部消融

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Typical atrial flutter is a macro-reentrant arrhythmia within the right atrium. Its zone of slow conduction is the so-called right atrial isthmus, representing the area between inferior vena cava, tricuspid annulus, and coronary sinus. Conduction block of this target area can terminate the arrhythmia and prevent reinduction. Isthmus ablation with radiofrequency (RF) energy is a well-established technique to produce conduction block. However, in most cases multiple energy applications are needed to create linear lesions. In individual cases, this results in prolonged procedure duration and, as a possible result of nontransmural lesions, recurrence of the arrhythmia. This article evaluates the feasibility and safety of a new steerable temperature-monitoring microwave ablation catheter in the production of linear lesions in the right atrial isthmus and examines both the dose-response relationship and the energy required for transmural lesions. Ablation was performed in eight open-chest mongrel dogs using a 2.450-MHz microwave generator with 35-50 W and a newly designed AFx 9-F deflectable catheter with a 25-mm antenna on the tip. The operation was performed under general anesthesia using nembutal and supported with room-air artificial respiration throughout the procedure. The study showed that the new deflectable AFx microwave catheter is a feasible and safe tool for creating long transmural linear lesions in the right isthmus. Based on this data, an appropriate catheter position, energy settings between 40 and 50 W, and application duration of approximately 90 s are needed. Also, the development of different antennas and curve shapes is recommended to simplify the ablation procedure and to target more complex arrhythmia substrates with microwave energy. Further studies are needed to determine the optimal anticoagulation procedure after microwave ablation.
机译：典型的心房扑动是右心房内的大型折返性心律不齐。其缓慢传导的区域是所谓的右房峡部，代表下腔静脉，三尖瓣环和冠状窦之间的区域。该目标区域的传导阻滞可终止心律不齐并防止还原。用射频（RF）能量消融峡部是一种成熟的产生传导阻滞的技术。但是，在大多数情况下，需要多次施加能量来产生线性损伤。在个别情况下，这会延长手术时间，并可能导致非透壁性病变，导致心律失常的复发。本文评估了一种新型的可控温度监测微波消融导管在右房峡部线性病变中的可行性和安全性，并研究了剂量反应关系和跨壁病变所需的能量。在8只开胸的杂种狗中进行消融，方法是使用功率为35-50 W的2.450 MHz微波发生器和尖端为25 mm天线的新设计的AFx 9-F可偏转导管。该手术是在全麻下使用戊巴比妥进行的，并在整个过程中进行室内空气人工呼吸。研究表明，新型可偏转AFx微波导管是在右峡部形成长的透壁线性病变的可行且安全的工具。根据此数据，需要适当的导管位置，40至50 W之间的能量设置以及大约90 s的应用持续时间。另外，建议开发不同的天线和曲线形状，以简化消融过程，并以微波能量靶向更复杂的心律不齐基质。需要进一步的研究以确定微波消融后的最佳抗凝程序。

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