Abstract
Objectives: Clinical success of atrial fibrillation (AF) ablation depends on persistent blocking of electrical conduction across the ablation lines. Epicor high-intensity focused ultrasound (HIFU) ablation has been credited with a variable clinical efficacy. The aim of this work is to ascertain the electrophysiological (EP) efficacy of such lesions, by assessing pulmonary vein isolation (PVI) after open chest HIFU ablation, in the clinical setting. Methods: Ten consecutive mitral patients (mean age: 57 ± 10 years) with paroxysmal AF undergoing concomitant ablation with the Epicor ablation system (St. Jude Inc.®, Minneapolis, MN, USA) were enrolled for EP assessment. During surgery, pairs of additional temporary wires were positioned on the right PVs (RPVs) and on the roof of the left atrium (RLA), before epicardial ablation. Exit block (no capture during PV pacing) of RPV and of RLA was assessed before, after ablating and immediately after closure of the chest, in order to check the correct positioning of the wires. EP assessment was repeated before discharge and at 3 weeks. Results: Baseline RPV pacing threshold (PT) was 3.5 ± 2 mA (range 1.5-8), of RLA 1.73 ± 1.1 mA (range 0.7-4.3 mA). PVI was not reached any time after HIFU ablation. At the pre-discharge EP study, the absence of isolation was observed in all cases. At 3 weeks, the PTs were 6.8 ± 5.8 mA on RPV (range 2-16) and 6.4 ± 5.3 mA (range 1-19) on RLA. All patients were discharged in sinus rhythm. CONCLUSIONS: PVI was not achieved after Epicor HIFU ablations, up to 3 weeks after surgery.
| Original language | English |
|---|---|
| Article number | ezr270 |
| Pages (from-to) | 129-134 |
| Number of pages | 6 |
| Journal | European Journal of Cardio-thoracic Surgery |
| Volume | 42 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jul 2012 |
Fingerprint
Keywords
- Arrhythmia
- Atrial fibrillation
- Conduction block
- HIFU ablation
- High-intensity focused ultrasound
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
- Pulmonary and Respiratory Medicine
- Medicine(all)
Cite this
Electrophysiological efficacy of Epicor high-intensity focused ultrasound. / Pozzoli, Alberto; Benussi, Stefano; Anzil, Federico; Taramasso, Maurizio; Privitera, Ylenia Adelaide; Cianflone, Domenico; Bella, Paolo Della; Alfieri, Ottavio.
In: European Journal of Cardio-thoracic Surgery, Vol. 42, No. 1, ezr270, 07.2012, p. 129-134.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Electrophysiological efficacy of Epicor high-intensity focused ultrasound
AU - Pozzoli, Alberto
AU - Benussi, Stefano
AU - Anzil, Federico
AU - Taramasso, Maurizio
AU - Privitera, Ylenia Adelaide
AU - Cianflone, Domenico
AU - Bella, Paolo Della
AU - Alfieri, Ottavio
PY - 2012/7
Y1 - 2012/7
N2 - Objectives: Clinical success of atrial fibrillation (AF) ablation depends on persistent blocking of electrical conduction across the ablation lines. Epicor high-intensity focused ultrasound (HIFU) ablation has been credited with a variable clinical efficacy. The aim of this work is to ascertain the electrophysiological (EP) efficacy of such lesions, by assessing pulmonary vein isolation (PVI) after open chest HIFU ablation, in the clinical setting. Methods: Ten consecutive mitral patients (mean age: 57 ± 10 years) with paroxysmal AF undergoing concomitant ablation with the Epicor ablation system (St. Jude Inc.®, Minneapolis, MN, USA) were enrolled for EP assessment. During surgery, pairs of additional temporary wires were positioned on the right PVs (RPVs) and on the roof of the left atrium (RLA), before epicardial ablation. Exit block (no capture during PV pacing) of RPV and of RLA was assessed before, after ablating and immediately after closure of the chest, in order to check the correct positioning of the wires. EP assessment was repeated before discharge and at 3 weeks. Results: Baseline RPV pacing threshold (PT) was 3.5 ± 2 mA (range 1.5-8), of RLA 1.73 ± 1.1 mA (range 0.7-4.3 mA). PVI was not reached any time after HIFU ablation. At the pre-discharge EP study, the absence of isolation was observed in all cases. At 3 weeks, the PTs were 6.8 ± 5.8 mA on RPV (range 2-16) and 6.4 ± 5.3 mA (range 1-19) on RLA. All patients were discharged in sinus rhythm. CONCLUSIONS: PVI was not achieved after Epicor HIFU ablations, up to 3 weeks after surgery.
AB - Objectives: Clinical success of atrial fibrillation (AF) ablation depends on persistent blocking of electrical conduction across the ablation lines. Epicor high-intensity focused ultrasound (HIFU) ablation has been credited with a variable clinical efficacy. The aim of this work is to ascertain the electrophysiological (EP) efficacy of such lesions, by assessing pulmonary vein isolation (PVI) after open chest HIFU ablation, in the clinical setting. Methods: Ten consecutive mitral patients (mean age: 57 ± 10 years) with paroxysmal AF undergoing concomitant ablation with the Epicor ablation system (St. Jude Inc.®, Minneapolis, MN, USA) were enrolled for EP assessment. During surgery, pairs of additional temporary wires were positioned on the right PVs (RPVs) and on the roof of the left atrium (RLA), before epicardial ablation. Exit block (no capture during PV pacing) of RPV and of RLA was assessed before, after ablating and immediately after closure of the chest, in order to check the correct positioning of the wires. EP assessment was repeated before discharge and at 3 weeks. Results: Baseline RPV pacing threshold (PT) was 3.5 ± 2 mA (range 1.5-8), of RLA 1.73 ± 1.1 mA (range 0.7-4.3 mA). PVI was not reached any time after HIFU ablation. At the pre-discharge EP study, the absence of isolation was observed in all cases. At 3 weeks, the PTs were 6.8 ± 5.8 mA on RPV (range 2-16) and 6.4 ± 5.3 mA (range 1-19) on RLA. All patients were discharged in sinus rhythm. CONCLUSIONS: PVI was not achieved after Epicor HIFU ablations, up to 3 weeks after surgery.
KW - Arrhythmia
KW - Atrial fibrillation
KW - Conduction block
KW - HIFU ablation
KW - High-intensity focused ultrasound
UR - http://www.scopus.com/inward/record.url?scp=84871697404&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84871697404&partnerID=8YFLogxK
U2 - 10.1093/ejcts/ezr270
DO - 10.1093/ejcts/ezr270
M3 - Article
C2 - 22253374
AN - SCOPUS:84871697404
VL - 42
SP - 129
EP - 134
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
SN - 1010-7940
IS - 1
M1 - ezr270
ER -