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May 21, 2019Journal of Cardiovascular Electrophysiology

Double cryoenergy application in a piglet model caused minor coronary artery injury in 2 of 29 lesions and produced ventricular lesions deeper than atrial lesions (4.06 vs 3.58 mm, P<0.05).

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Why the study?

Double cryoenergy application was introduced into clinical practice due to single-application inferiority to RFA, but experience regarding efficacy and coronary artery damage was limited.

Does double cryoenergy application create effective lesion volumes and what is the risk of coronary artery damage in a growing myocardium model?

Population

Five piglets

Comparison

Two sequential cycles of cryoenergy at -75°C for 4 minutes at the atrioventricular groove

Design

Animal study

Follow-up

6 months

Key result

Double cryoenergy application in a piglet model caused minor coronary artery injury in 2 of 29 lesions and produced ventricular lesions deeper than atrial lesions (4.06 vs 3.58 mm, P<0.05).

Authors

HSHeike SchneiderMSMaja StahlWSWolfgang Schillinger

Discussion

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Member takes

Overview

Minor coronary injury risk in piglet model warrants histologic caution in immature hearts; leaves open translation to pediatric ablation.

Structured PICO

Does double cryoenergy application create effective lesion volumes and what is the risk of coronary artery damage in a growing myocardium model?

P
Population
Five piglets (growing myocardium model)
I
Intervention
Two sequential cycles of cryoenergy delivered at -75°C for 4 minutes at the atrioventricular groove
O
Outcome
Lesion volume (efficacy) and risk of coronary artery damage (safety) assessed by histology, coronary angiography, and intracoronary ultrasound at 6 monthssafety

Double cryoenergy application in a growing myocardium piglet model creates effective lesions but can cause subclinical minor coronary artery wall injury detectable only by histology.

Limitations

  • Lifetime sequelae of subclinical minor affection of the coronary artery wall remains unknown

Cite This Study

Schneider et al. (2019) studied Growing myocardium (piglet model) (n=5). Double cryoenergy application was evaluated on Lesion volume and risk of coronary artery damage. Double cryoenergy application in a piglet model caused minor coronary artery injury in 2 of 29 lesions and produced ventricular lesions deeper than atrial lesions (4.06 vs 3.58 mm, P<0.05).

synapsesocial.com/papers/6a10d07b49545a83bbee6dd3https://doi.org/10.1111/jce.13993
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cryoablation at Growing Myocardium: No Evidence of Coronary Artery Obstruction or Intimal Plaque Formation Early and Late after Energy Application2009 · 27 citations
  2. 2Enlargement of Catheter Ablation Lesions in Infant Hearts With Cryothermal Versus Radiofrequency Energy2011 · 45 citations
  3. 3Efficacy and Safety of Cryoenergy in the Ablation of Atrioventricular Reentrant Tachycardia Substrates in Children and Adolescents2005 · 112 citations
  4. 4Linear epicardial cryoablation effects in a porcine model: Lesion characteristics and vascular risk2023 · 5 citations
  5. 5The influence of epicardial and endocardial use of cryoenergy on the completeness of lesions in surgical ablation of atrial fibrillation2020 · 2 citations