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Ultralow temperature cryoablation: Safety and efficacy of preclinical atrial and ventricular lesions. | LitMetric

AI Article Synopsis

  • Ultralow temperature cryoablation (ULTC) is a technique aimed at creating specific lesions in the heart, and this study evaluated its safety and effectiveness in large animal models.
  • The study involved using special catheters cooled with nitrogen to create lesions in the hearts of swine and sheep, with results showing a high success rate in eliminating electrical signals in targeted areas.
  • Findings indicated that ULTC produced deep, consistent lesions in the heart tissue that remained intact over three months, with minimal risks of complications such as damage to surrounding tissues.

Article Abstract

Background: Ultralow temperature cyroablation (ULTC) is designed to create focal, linear, and circumferential lesions. The aim of this study was to assess the safety, efficacy, and durability of atrial and ventricular ULTC lesions in preclinical large animal models.

Methods And Results: The ULTC system uses nitrogen near its liquid-vapor critical point to cool 11-cm ablation catheters. The catheter can be shaped to specific anatomies using pre-shaped stylets. ULTC was used in 11 swine and four sheep to create atrial (pulmonary vein isolation and linear ablation) and ventricular lesions. Acute and 90-day success were evaluated by intracardiac mapping and histologic examination. Cryoadherence was observed during all ULTC applications, ensuring catheter stability at target locations. Local electrograms were completely eliminated immediately after the first single-shot ULTC application in 49 of 53 (92.5%) atrial and in 31 of 32 (96.9%) ventricular applications. Lesion depth as measured on histology preparations was 1.96 ± 0.8 mm in atrial and 5.61 ± 2.2 mm in ventricular lesions. In all animals, voltage maps and histology demonstrated transmural and durable lesions without gaps, surrounded by intact collagen fibers without injury to surrounding tissues. Transient coronary spasm could be provoked with endocardial ULTC in the left ventricle in close proximity to a coronary artery.

Conclusions: ULTC created effective and efficient atrial and ventricular lesions in vivo without procedural complications in two large animal models. ULTC lesions were transmural, contiguous, and durable over 3 months.

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Source
http://dx.doi.org/10.1111/jce.14907DOI Listing

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