Abstract
Catheter mediated electrical ablation of posterior septal accessory pathways is appealing not only because of the opportunity to avoid a sternotomy but also because posterior septal accessory pathways are recognized as the most difficult type of accessory pathway to ablate surgically [1]. Previous work has documented that catheter mediated electrical ablation of posterior septal accessory pathways is, indeed, clinically feasible although with variable success [2–8]. The purpose of this chapter is to review our work investigating the histologic effects of single, damped sine wave defibrillator pulses on the canine proximal coronary sinus (CS) in order to gain insight into the factors leading to success or failure of the technique for posterior septal accessory pathway ablation in man [9–12].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Gallagher JJ, Sealy WC, Cox JL, German LD, Kasell JH, Bardy GH, Packer DL: Results of surgery for preexcitation caused by accessory atrioventricular pathways in 267 consecutive cases. In: Tachycardias: Mechanisms, Diagnosis, Treatment. ME Josephson, HJJ Wellens, ed. Philadelphia Lea & Febiger, p. 259, 1984.
Critelli G, Monda V, Perticone F, Coltorti F, Scherillo M, Condorelli M: Closed chest ablation of accessory pathways. Experimental model and successful application in a patient with incessant supraventricular tachycardia. G Ital Cardiol 14/I: 181, 1984.
Morady F, Scheinman MM: Transvenous catheter ablation of a postero-septal accessory pathway in a patient with the Wolff-Parkinson-White syndrome. N Engl J Med 310: 705, 1984.
Fisher JD, Brodman R, Kim SG, Matos JA, Brodman E, Wallerson D, Waspe LE: Attempted nonsurgical electrical ablation of accessory pathways via the coronary sinus in the Wolff-Parkinson-White syndrome. JACC 4: 685, 1984.
Bardy GH, Poole JE, Coltorti F, Ivey TD, Block TA, Greene HL: Catheter ablation of a concealed posteroseptal accessory pathway. Am J Cardiol 54: 1366, 1984.
Ward DE, Camm JA: Treatment of tachycardias associated with the Wolff-Parkinson-White syndrome by transvenous electrical ablation of accessory pathways. Br Heart J 53: 64, 1985.
Nathan AW, Davies DW, Creamer JE, Camm J: Successful catheter ablation of abnormal atrioventricular pathways in man. In: Cardiac Pacing: Electrophysiology, Tachyarrhythmias. F Perez-Gomez, ed. Madrid: Editorial Group, p. 1588, 1985.
Morady F, Scheinman MM, Winston SA, Di Carlo LA Jr., Davis JC, Griffin JC, Ruder M, Abbott JA, Eldar M: Efficacy and safety of transcatheter ablation of posteroseptal accessory pathways. Circulation 72: 170, 1985.
Coltorti F, Bardy GH, Reichenbach D, Greene HL, Thomas B, Breazeale DG, Alferness C, Ivey TD: Catheter mediated electrical ablation of the posterior ventricular septum via the coronary sinus: Electrophysiologic and histologic observations in dogs. Circulation 72: 612–622, 1985.
Bardy GH, Coltorti F, Ivey TD, Alferness C, Rackson M, Hansen K, Stewart R, Greene HL: Some factors affecting bubble formation during catheter mediated electrical pulses. Circulation 73: 525–538, 1986.
Coltorti F, Bardy GH, Reichenbach D, Greene HL, Thomas R, Breazeale DG, Ivey TD: Electrophysiologic and histologic observations following catheter-mediated defibrillator pulses at the coronary sinus orifice in dogs: Effects of varying electrode configuration. Circulation 73: 1321–1333, 1986.
Bardy GH, Coltorti F, Ivey TD, Yerkovich D, Greene HL: Effect of damped sine-wave shocks on catheter dielectric strength. Am J Cardiol 56: 769–772, 1985.
MacAlpine WA: Heart and Coronary Arteries. Berlin: Springer-Verlag, pp. 50, 63, 1975.
Früngel FBA: High speed Pulse Technology, Vol 1. New York: Academic Press, pp. 476–483, 1965.
Tidd MJ, Webster J, Cameron Wright H, Harrison IR: Mode of action of a surgical electronic lithoclast — high speed pressure, cinematographic and Schlieren recordings following an ultrashort underwater electronic discharge. Biomed Eng (London) II: 5, 1976.
Cobine JD: Gaseous Conductors. Theory and Engineering Applications. New York: McGraw-Hill Book Co, pp. 143–204, 1941.
Cobine JD: Gaseous Conductors. Theory and Engineering Applications. New York: McGraw-Hill Book Co, pp. 290–293, 1941.
Brown SC: Basic Data of Plasma Physics. New York: John Wiley & Sons, pp. 270–271, 1959.
Brown SC: Basic Data of Plasma Physics. New York: John Wiley & Sons, pp. 319, 1959
Bradley JN: Shock Waves in Chemistry and Physics. London: Butler and Tanner Ltd, pp. 1–2, 1962.
Bell CE, Landt JA: Laser-induced high pressure shock waves in water. Appl Physics Lett 10: 46, 1967.
Martynenko OG, Stolovich NN, Rudin GI, Levchenko SA: Shock waves in water induced by focused laser radiation. In: Shock Waves, Explosions, and Detonations. Progress in Astronautics and Aeronautics. JR Bowen, N Manson, AK Oppenheim, RI Soloukhin, ed. New York: AIAA, vol 87, pp. 64–70, 1981.
Dahl CF, Ewy GA, Warner ED, Thomas ED: Myocardial necrosis from direct current discharge: Effect of paddle electrode size and time interval between discharges. Circulation 50: 956, 1974.
Doherty PW, McLaughin PR, Billingham M, Kernoff R, Goris ML, Harrison DC: Cardiac damage produced by direct current countershocks applied to the heart. Am J Cardiol 43: 225, 1979.
Anderson HN, Reichenbach D, Steinmetz GP, Merendino KA: An evaluation and comparison of effects of alternating and direct current electrical discharges on canine hearts. Ann Surg 160: 251, 1964.
Ewy GA, Taren D, Bangert J, McClung S, Hellman DA: Comparison of myocardial damage from defibrillator discharges at various dosages. Med Instrum 14: 9, 1980.
Van Vleet JF, Tacker WA Jr, Geddes LA, Ferrans VJ: Sequential cardiac morphologic alterations induced in dogs by single transthoracic damped sinusoidal waveform defibrillator shocks. Am J Vet Res 39: 271, 1978.
Van Vleet JF, Tacker WA Jr, Geddes LA, Ferrans VJ: Sequential ultrastructural alterations in ventricular myocardium of dogs given large single transthoracic damped sinusoidal waveform defibrillator shocks. Am J Vet Res 41: 493, 1980.
Barker-Voelz MA, Van Vleet JF, Tacker WA Jr, Bourland JD, Geddes LA, Schollmeyer MP: Alterations induced by a single defibrillating shock applied through a chronically implanted catheter electrode. J Electrocardiol 16: 167, 1983.
Lerman BB, Weiss JL, Bulkley BH, Becker LC, Weisfeldt ML: Myocardial injury and induction of arrhythmia by direct current shock delivered via endocardial catheters in dogs. Circulation 69: 1006, 1984.
Bardy GH, Ideker RE, Kasell J, Worley SJ, Smith WM, German LD, Gallagher JJ: Transvenous ablation of the atrioventricular conduction system in dogs: Electrophysiologic and histologic observations. Am J Cardiol 51: 1775, 1983.
Reichenbach D, Benditt EP: Myofibrillar degeneration: A response of the myocardial cell to injury. Arch Pathol Lab Med 85: 189, 1968.
Fisher JD, Brodman R, Johnston DR, Waspe LE, Kim SG, Matos JA, Scavin G: Nonsurgical electrical ablation of tachycardias: Importance of prior in vitro testing of catheters. PACE 7: 74, 1984.
Lunel AAV: Significance of annulus fibrosus of heart in relation to AV conduction and ventricular activation in cases of Wolff-Parkinson-White syndrome. Br Heart J 34: 1263–1271, 1972.
Becker AE, Anderson RH, Durrer D, Wellens HJJ: The anatomical substrates of Wolff-Parkinson-White syndrome. A clinicopathologic correlation in 7 patients. Circulation 57: 870–879, 1978.
Klein GJ, Hackel DB, Gallagher JJ: Anatomic substrate of impaired antegrade conduction over an accessory atrioventricular pathway in the Wolff-Parkinson-White syndrome. Circulation 61: 1249–1256, 1980.
Bardy GH, Coltorti F, Rackson MM, Hansen K, Greene HL, Ivey TD. Current waveform modulation to avoid plasma-arcing and barotrauma with catheter mediated electric discharges. American Heart Association. Washington D.C., November 11–14, 1985.
Bardy GH, Coltorti F, Rackson MM, Hansen K, Greene HL, Ivey TD. Multiple vs single pulses to avoid voltage breakdown and shock-wave generation with catheter mediated electrical pulses. American College of Cardiology. Atlanta, GA. March 9–13, 1986.
Bardy GH, Coltorti F, Rackson MM, Hansen K, Greene HL, Ivey TD. Catheter mediated electrical ablation: The relation between current and pulse width on voltage breakdown and shock-wave generation. American College of Cardiology. Atlanta, GA March 9–13, 1986.
Bardy GH, Coltorti F, Stewart R, Hansen K, Greene HL, Ivey TD: The role of duty factor in preventing voltage breakdown during delivery of modulated electric pulses to a catheter. North American Society of Pacing and Electrophysiology. New Orleans, LA May 15–17, 1986.
Bardy GH, Coltorti, Greene HL, Ivey TD: Catheter mediated electrical ablation: The relation between current and pulse width on voltage breakdown and shock-wave generation. Cardiostim 86, Monaco June 19–21, 1986.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1988 Martinus Nijhoff Publishing, Boston
About this chapter
Cite this chapter
Bardy, G.H., Coltorti, F., Ivey, T.D., Stewart, R., Greene, H.L. (1988). Effects of High-Energy Electrical Shocks Delivered to the Atrium of the Coronary Sinus. In: Scheinman, M.M. (eds) Catheter Ablation of Cardiac Arrhythmias. Developments in Cardiovascular Medicine, vol 78. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1765-4_4
Download citation
DOI: https://doi.org/10.1007/978-1-4613-1765-4_4
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-8990-6
Online ISBN: 978-1-4613-1765-4
eBook Packages: Springer Book Archive