Why the study?
Does epicardially delivered Nd:YAG laser photoablation eliminate induced ventricular tachycardia in a post-infarction canine model?
Does epicardially delivered Nd:YAG laser photoablation eliminate induced ventricular tachycardia in a post-infarction canine model?
Epicardially delivered laser energy guided by electrical activation mapping is highly effective at ablating post-infarction ventricular tachycardia in a canine model.
Supports feasibility of epicardial laser ablation for post-MI VT in canines; leaves open clinical translation and human trials.
BACKGROUND AND OBJECTIVE: The purpose of this study was to evaluate the efficacy of epicardially delivered laser energy to ablate induced ventricular tachycardia in a post-infarction canine model. STUDY DESIGN/MATERIALS AND METHODS: In 13 canines, the left anterior wall myocardial infarction was created. Five days later, 240 plunged electrodes were inserted into the heart. Three-dimensional ventricular activation sequences were analyzed on line by a computerized mapping system. RESULTS: Sixteen sustained monomorphic ventricular tachycardias were reproducibly induced in 10 canines. Epicardially contacted Nd:YAG laser irradiated the areas of the final pathway in macro-reentrant activation and the impulse origin in focal excitation. Linear photocoagulation lesions (11-16 x 50-72 mm) were created. Seven macro-reentrant circuits and six of nine focal origins were eliminated (success rate 81%). Pathology showed that laser photocoagulation involved all surviving subepicardial and intramural fibers. CONCLUSION: Epicardially delivered laser energy in conjunction with electrical activation mapping has a high probability of ablating post-infarction ventricular tachycardia.
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Wu et al. (1997) studied this question.
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