Key result
Mapping guided laser catheter ablation safely produced reversible conduction disturbances with 9.7-second pulses and chronic block with 28.6-second pulses in dogs.
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Not ready for clinical translation; leaves open titratable laser ablation for human arrhythmia mapping.
Safety and efficacy of mapping guided laser catheter ablation of the AV junction was tested in a canine model. A total of 43 laser pulses (continuous wave, Nd:YAG, 1,064 nm, 30 W, irradiated spot diameter 2.0-2.5 mm) were delivered in 15 dogs (2-5 per dog) via a novel laser catheter system. Pulses were selectively aimed at: (1) the AV node; (2) the His bundle; and (3) the bundle branches. Laser pulses of 9.7 +/- 1.1 seconds (n = 31) produced reversible conduction disturbances in the targeted segment of the AV conduction system, while pulses of 28.6 +/- 7.9 seconds (n = 9) resulted in chronic block. The dogs survived the procedure without complications. Follow-up was 6.5-10.5 months. Histopathologically, lesions showed clear-cut oval-shaped areas of fibrosis of 0.5-18.0 mm in diameter and 0.5-3.5 mm (transmural) in depth, depending on the irradiation time. Pervenous mapping guided laser catheter irradiation of the AV junction can produce AV block consistently and selectively in the targeted segment of the right ventricular conduction system in dogs. The method is safe and can be performed in a controllable manner by using the catheter system presented.
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Weber et al. (1996) studied Atrioventricular conduction ablation (n=15). Mapping guided laser catheter ablation was evaluated on Conduction disturbances and chronic block. Mapping guided laser catheter ablation safely produced reversible conduction disturbances with 9.7-second pulses and chronic block with 28.6-second pulses in dogs.
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