Key result
The novel Cryo1-probe created transmural lesions in 99% of cross-sections, similar to the 98% achieved by the 3011 Maze-Linear probe, with no significant difference in lesion width or depth.
Why the study?
Does the novel Cryo1-probe create transmural lesions comparable to the 3011 Maze-Linear probe in a chronic porcine model?
Does the novel Cryo1-probe create transmural lesions comparable to the 3011 Maze-Linear probe in a chronic porcine model?
The novel Cryo1-probe effectively creates transmural lesions on the beating heart with sustained conduction delay, performing similarly to the standard 3011 Maze-Linear probe in a porcine model.
Comparable lesion creation in porcine model supports further development; clinical translation and safety remain untested.
OBJECTIVE: Cryoablation is commonly used at present in the surgical treatment of atrial fibrillation. However, there have been few studies examining the efficacy of the commonly used ablation devices. This report compares the efficacy of two cryoprobes in creating transmural endocardial lesions on the beating heart in a chronic porcine model. METHODS: In 6 Hanford-miniature-swine, the right atrial appendage and the inferior vena cava were isolated using a bipolar radiofrequency-clamp to create areas of known conduction block. A connecting ablation line was performed endocardially via a purse-string with the novel malleable 10cm Cryo1-probe for 2 minutes at −40°C. Additional ablation lines were created with the Cryo1 and the 3.5cm 3011 Maze-Linear probe on the right and left atrial wall. Epicardial activation mapping was performed prior to and immediately after ablation as well as 14 days postoperatively. Histology was performed 14 days postoperatively. RESULTS: Transmural lesions were confirmed in 83/84 cross-sections (99%) for the Cryo1-probe and in 40/41 cross-sections (98%) for the 3011 Maze-Linear probe. There was no difference between the devices in lesion width (Cryo1: 10.7±3.5mm; 3011: 10.0±3.9mm; p=0.31), lesion depth (Cryo1: 4.5±1.7mm; 3011: 4.6±1.5mm; p=0.74) or atrial wall thickness (Cryo1: 4.5±1.8mm; 3011: 4.7±1.7mm; p=0.74). There was a conduction delay across the right atrial ablation line (20±2ms vs. 51±8ms, p<0.001) that remained unchanged at 14 days (51±8ms vs. 52±10ms, p=0.88). CONCLUSIONS: The Cryo1-probe created transmural lesions on the beating heart resulting in sustained conduction delay. Both probes had similar performance in terms of lesion geometry in this chronic animal model.
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Weimar et al. (2012) studied Atrial fibrillation (surgical treatment model) (n=6). Cryo1-probe vs. 3011 Maze-Linear probe was evaluated on Transmural lesions confirmed in cross-sections. The novel Cryo1-probe created transmural lesions in 99% of cross-sections, similar to the 98% achieved by the 3011 Maze-Linear probe, with no significant difference in lesion width or depth.
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