Ablation of ventricular tachycardia using multiple sequential transcatheter application of radiofrequency energy.

摘要: Multiple sequential radiofrequency energy was applied in the left and right ventricles of 24 dogs to produce large ablated areas limited endocardial subendocardial regions. Endocardial ablation performed nine with normal 15 that had survived remote myocardial infarcts, three inducible sustained monomorphic ventricular tachycardia. A quadripolar catheter positioned either at site earliest activation during induced tachycardia or circumscribed ventricle. Radiofrequency delivered between two adjacent poles catheter, successively applying distal, middle, proximal electrode pairs; this repeated 9 11 times a slightly different position. cumulative 9,688 +/- 4,191 joules resulted an endocardial/subendocardial surface area 4.7 2.2 cm2 (range 2.4-10 cm2, maximum depth 4 mm). Sustained not by aggressive programmed stimulation previously tachycardia, indicating successful foci. Only seven were available for electrophysiological studies; used acute four chronic studies. Ventricular remaining before after ablation, lack arrhythmogenic effect method. Histologic examination all (five sacrificed pathological examination) as well infarction. The late lesion these 19 animals showed homogeneous coagulation necrosis proliferation. Thus, modified technique produced scars suitable treating no evidence influence.