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Development of a novel ablation hood to prevent systemic embolization of microbubbles and particulate emboli

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Abstract

Background

Atrial fibrillation ablation results in microbubbles and particulate emboli formation. We aimed to develop and test the early feasibility of a novel ablation hood to contain microbubbles and particulate emboli with the ultimate goal of preventing systemic embolization.

Methods

In seven canines, we developed, iterated, and tested a novel retractable hood that can cover the catheter-tissue ablation site. The number and volume (nL) of microbubbles formed during ablation with and without the hood was measured using an extracorporeal circulation loop. Wilcoxon’s signed-rank test was used to compare the number of bubbles detected with and without the hood.

Results

The hood reduced systemic embolization of microbubbles in 21/28 (75%) of ablations. Both atrial and ventricular ablations showed a statistically significant reduction in bubble number (476 ± 811 without hood vs 173 ± 226 with hood, p = 0.02; 2669 ± 1623 without hood vs 1417 ± 970 with hood, p = 0.04, respectively) and bubble volume (3.3 ± 7.6 nL without hood vs 0.2 ± 0.56 nL with hood, p = 0.006; 6.1 ± 5.2 nL without hood vs 1.9 ± 1.4 nL with hood, p = 0.05, respectively).

Conclusions

Use of a novel hood to cover the ablation catheter at the site of catheter-tissue contact has the potential to provide a means to reduce systematic embolization of microbubbles. Further work is required to examine particulate emboli, but these data show the early feasibility of this design concept.

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Author information

Authors and Affiliations

  1. Division of Heart Rhythm, Department of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Alan Sugrue, Vaibhav Vaidya, Omar Yasin, Ameesh Isath, Anas Abudan, Deepak Padmanabhan, Suraj Kapa & Samuel J. Asirvatham

  2. Department of Pediatric and Adolescent Medicine/Division of Pediatric Cardiology, Mayo Clinic, Rochester, MN, USA

    Samuel J. Asirvatham

Authors
  1. Alan Sugrue
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  2. Vaibhav Vaidya
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  3. Omar Yasin
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  4. Ameesh Isath
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  5. Anas Abudan
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  8. Samuel J. Asirvatham
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Corresponding author

Correspondence to Samuel J. Asirvatham.

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SJA has intellectual property rights to the device described in this manuscript. The other authors declare that they have no conflict of interest.

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The Mayo Clinic Animal Care and Use Committee approved this study.

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Supplemental Figure 1

Increase in bubble count (arrow) after intentional loss of hood contact with the myocardium. (PNG 1255 kb)

High resolution image (TIF 3318 kb)

ESM 2

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Sugrue, A., Vaidya, V., Yasin, O. et al. Development of a novel ablation hood to prevent systemic embolization of microbubbles and particulate emboli. J Interv Card Electrophysiol 58, 281–288 (2020). https://doi.org/10.1007/s10840-019-00595-y

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  • DOI: https://doi.org/10.1007/s10840-019-00595-y

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