Key result
Selective ablation of interatrial conduction pathways using a novel mesh electrode catheter eliminated atrial fibrillation inducibility in all 5 susceptible pigs without affecting AV nodal conduction.
Why the study?
Does selective ablation of interatrial conduction pathways using a novel mesh electrode catheter alter interatrial conduction and prevent atrial fibrillation inducibility in animal models?
Does selective ablation of interatrial conduction pathways using a novel mesh electrode catheter alter interatrial conduction and prevent atrial fibrillation inducibility in animal models?
Selective ablation of interatrial conduction pathways using a novel mesh electrode catheter successfully eliminated interatrial conduction and prevented atrial fibrillation inducibility in animal models without affecting AV nodal conduction.
Novel catheter ablation of interatrial pathways is feasible in dogs; leaves open human translation and clinical utility.
BACKGROUND: Interatrial conduction occurs via discrete pathways along the coronary sinus musculature, fossa ovalis region, and Bachman's bundle. We assessed the feasibility of altering interatrial conduction by selectively ablating two of these conduction pathways using a novel mesh electrode ablation catheter. METHODS: Circular radiofrequency energy catheter ablation lesions were created in the proximal coronary sinus in four dogs and in both the fossa ovalis and the proximal coronary sinus regions in seven pigs. Interatrial conduction was assessed by analyzing intracardiac electrogram and noncontact isopotential mapping data. Inducibility of atrial fibrillation was assessed before and after ablation (in six pigs). RESULTS: Ablation lesions in the proximal coronary sinus eliminated interatrial conduction along the coronary sinus musculature in four dogs and five of seven pigs. Ablation lesions in the fossa ovalis region eliminated interatrial conduction via midseptal pathways in six of seven pigs. Atrial fibrillation, inducible in five of seven pigs at baseline, was rendered noninducible in all five. There was no adverse effect on AV nodal conduction. CONCLUSIONS: (1) Using a novel mesh electrode ablation catheter, we were able to ablate interatrial conduction pathways along the proximal coronary sinus and fossa ovalis regions. (2) This altered interatrial conduction and altered atrial fibrillation inducibility and maintenance. (3) Catheter ablation of interatrial conduction pathways may be useful in the therapy of atrial fibrillation.
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Ott et al. (2007) studied Atrial fibrillation (n=11). Selective ablation using a novel mesh electrode ablation catheter vs. Baseline (before ablation) was evaluated on Inducibility of atrial fibrillation and elimination of interatrial conduction. Selective ablation of interatrial conduction pathways using a novel mesh electrode catheter eliminated atrial fibrillation inducibility in all 5 susceptible pigs without affecting AV nodal conduction.
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