Laser photoablation of experimental post-infarction ventricular tachycardia guided by three dimensional activation mapping
✍ Scribed by Wu, Guanglie; Svenson, Robert H.; Littmann, Laszlo; Chuang, Chi Hui; Thompson, Michelle; Nanney, Glenn A.; Splinter, Robert; Tatsis, George P.; Dezern, Kathy R.
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 826 KB
- Volume
- 20
- Category
- Article
- ISSN
- 0196-8092
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✦ Synopsis
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 × 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.