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The Effects of High-Energy DC Shocks Delivered to Ventricular Myocardium

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Catheter Ablation of Cardiac Arrhythmias

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 78))

Abstract

Endocardial catheter fulguration is a new method for the treatment of cardiac arrhythmias which has been used to interrupt the AV conduction system, to prevent rapid ventricular rates originating in the atrium. It could also be applied to atrial or ventricular myocardium to directly modify the arrhyth-mogenic substrate. Clinical successes obtained with this technique have spurred its clinical applications before systematic studies of the equipment [1–4], physics [5–13], and its biological consequences have been sufficiently investigated in the animal laboratory [14–25]. The present work reports the canine experiments performed in the Laboratoire de Chirurgie Experimentale of Pr. C. Cabrol’s group at Hospitalo-Universitaire Pitie-Salpetriere in Paris between April 1982 and March 1984 [18].

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References

  1. Bardy CH, 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.

    Article  PubMed  CAS  Google Scholar 

  2. Fisher JD, Brodman R, Johnson D, Waspe LE, Kim SG, Matos JA, Scavin G: Nonsurgical electrical ablation of tachycardia: Importance of in vitro testing of catheter leads. PACE 7: 74–81, 1984.

    PubMed  CAS  Google Scholar 

  3. Fontaine G, Cansell A, Lechat P, Frank R, Tonet JL, Grosgogeat Y: Les chocs electriques endocavitaires. Problemes lies au materiel. Arch Mal Coeur 77: 1307–1314, 1984.

    PubMed  CAS  Google Scholar 

  4. Fontaine G, Cansell A, Lechat P, Grosgogeat Y: A non destructive method to select catheters for ablation technique. Eur Heart J 5: (SPI); 258 (abstract), 1984.

    Google Scholar 

  5. Bardy GH, Coltorti F, Ivey TD, Alferness C, Rackson M, Hansen K, Stewart R, Greene HL: Some factors affecting bubble formation with catheter-mediated defibrillator pulses. Circulation 73: 525–538, 1986.

    Article  PubMed  CAS  Google Scholar 

  6. Downar E, Harris L, Parson I, Easty A: Characterisation of catheter ablation with high speed cinematography JACC 7: 131-A (abstract), 1986.

    Google Scholar 

  7. Boyd EG, Holt PM: An investigation into the electrical ablation technique and a method of electrode assessment. PACE 8: 815–824, 1985.

    PubMed  CAS  Google Scholar 

  8. Boyd EG, Holt PM: Haematological effects of the ablation technique: A comparison between anodal and cathodal delivery JACC 7: 131-A (abstract), 1986.

    Google Scholar 

  9. Boyd EG, Holt PM, Sowton E: Patient impedance-time characteristics during unipolar ablation: A critical factor in the energy delivery system specification PACE 9: 298 (abstract), 1986.

    Google Scholar 

  10. Fontaine G, Volmer W, Nienaltowska E, Aaddaj S, Cansell A, Grosgogeat Y: Approach to the physics of fulguration. In: Ablation in Cardiac Arrhythmias, G Fontaine, MM Scheinman, eds. Mount Kisco: Futura Publishing Company, 1987, p. 101.

    Google Scholar 

  11. Wetherbee JN, Chapman PD, Klopfenstein HS, Troup PJ: Is the truncated exponential waveform safer for catheter ablation? Circulation 72: (Suppl III); 390 (abstract), 1985.

    Google Scholar 

  12. Nienaltowska E, Fruman DH, Fontaine G: Cavitation within the heart: A treatment of cardiac arrhythmias. In: Proceedings of the American Society of Mechanical Engineers — Atlanta, May 1986.

    Google Scholar 

  13. Lee BI, Rodriguez ER, Notargiacomo A, Ferrans VJ, Chen YW, Fletcher RD: Thermal effects of laser and electrical discharge on cardiovascular tissue: Implications for coronary artery recanalization and endocardial ablation. JAAC 8: 193–200, 1986.

    CAS  Google Scholar 

  14. Westveer DC, Nelson T, Stewart JR, Thornton EP, Gordon S, Timmis GC: Sequelae of left ventricular electrical endocardial ablation. JACC 5: 956–960, 1985.

    PubMed  CAS  Google Scholar 

  15. Ruder MA, Davis JC, Eldar M, Scheinman MM: Effects of electrode catheter shocks delivered near the tricuspid annulus in dogs JACC 7: 7 (abstract), 1986.

    Google Scholar 

  16. Levine JH, Spear JF, Weisman HF, Prood C, Kadish AA, de Langen C, Moore EN: Abnormal impulse conduction and initiation are present in a large border zone after high energy ablation JACC 7: 37 (abstract), 1986.

    Google Scholar 

  17. Levine JH, Spear JF, Prood C, Kadish AA, de Langen C, Moore EN: The importance of current pathway in ablation: In vitro and in vivo correlates Circulation 72 (Suppl III): 390 (abstract), 1985.

    Google Scholar 

  18. Lechat P, Fontaine G, Cansell A, Grosgogeat Y: Epicardial and endocardial myocardial damage related to catheter ablation techniques Eur Heart J 5 (Suppl 1): 258, 1984.

    Google Scholar 

  19. Kempf F, Falcone RA, Iozzo RV, Josephson ME: Anatomic and hemodynamic effects of catheter-delivered ablation energies in the ventricle. Am J Cardiol 56: 373–377, 1985.

    Article  PubMed  Google Scholar 

  20. Hauer RN, Straks W, Borst C, Robles de Medina EO: Electrical catheter ablation in the left and right ventricular wall in dogs: Relation between delivered energy and histopathologic changes. JACC 8: 637–643, 1986.

    PubMed  CAS  Google Scholar 

  21. Coltorti F, Bardy GH, Reichenbach DD, Greene HL, Thomas RC, Breazeale DG, Ivey TD: Effects of varying electrode configuration with catheter-mediated defibrillator pulses at the coronary sinus orifice in dogs. Circulation 6: 1321–1333, 1986.

    Article  Google Scholar 

  22. Chapman PD, Klopfenstein HS, Troup PJ, Brooks HL: Evaluation of a percutaneous catheter technique for ablation of ventricular tachycardia in a canine model. Am Heart J 110: 1, 1985.

    Article  PubMed  CAS  Google Scholar 

  23. Brodman R, Fisher JD: Evaluation of a catheter technique for ablation of accessory pathways near the coronary sinus using a canine model. Circulation 67: 923–929, 1983.

    Article  PubMed  CAS  Google Scholar 

  24. Beazell JW, Adomian GE, Furmanski M, Tan KS: Experimental production of complete heart block by electrocoagulation in the closed chest dog. Am Heart J 104: 1328, 1982.

    Article  PubMed  CAS  Google Scholar 

  25. Bardy GH, Kasell JH, Ideker RE, Worley SJ, Smith WM, German LD, Gallagher JJ: Transvenous catheter ablation of the atrioventricular conduction system for treatment of refractory supraventricular tachycardia. Electrophysiologic and pathologic observations in dogs. Am J Cardiol 49: 1012, 1982.

    Article  Google Scholar 

  26. Fontaine G, Volmer W, Nienaltowska E, Aaddaj S, Cansell A, Grosgogeat Y: Approach to the physics of fulguration. In: Ablation in Cardiac Arrhythmias, G Fontaine, MM Scheinman, eds. Mount Kisco: Futura Publishing Company, 1987, p. 101.

    Google Scholar 

  27. Fontaine G, Cansell A, Lechat P, Frank R, Grosgogeat Y: Method of selecting catheters for endocavitary fulguration. Stimucoeur 12: 285–289, 1984.

    Google Scholar 

  28. Lee BI, Notargiacomo A, Fletcher RD, Rodriguez ER, Ferrans VJ, Chen YW: The thermal response of ventricular endocardium to laser and electrical ablation and the disparate effects of different superfusion media JACC 7: 37 (abstract), 1986.

    Google Scholar 

  29. Plesset MS, Prosperetti A: Bubble dynamics and cavitation. Ann Rev Fluid Mech 9: 145–185, 1977.

    Article  CAS  Google Scholar 

  30. Tidd MJ, Webster J, Cameron Wroght 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 Engin 1: 5–11, 1976.

    Google Scholar 

  31. Van Vleet JF, Tacker WA, Geddes LA, Ferrans VF: Acute cardiac damage in dogs given multiple transthoracic shocks with a trapezoidal waveform defibrillator. Am J Vet Res 38: 617–626, 1977.

    PubMed  Google Scholar 

  32. Dahl CF, Ewy GA, Warner ED, Thomas ED: Myocardial necrosis from direct current countershock. Effect of paddle electrode size and time interval between discharges. Circulation 50: 956–961, 1974.

    PubMed  CAS  Google Scholar 

  33. Laniado S, Buckley NM, Frank CW, Kambosos D: Effects of DC electric countershock on ventricular function, cation balance and endogenous norepinephrine in the dog heart. Cardiology 59: 253–267, 1974.

    Article  PubMed  CAS  Google Scholar 

  34. Mac Lean LD, Van Tyn RA: Ventricular defibrillation. An experimental investigation of voltage requirements and effect of electrode size. JAMA 175: 471–474, 1961.

    CAS  Google Scholar 

  35. Pansegrau DG, Abboud FM: Hemodynamic effects of ventricular defibrillation. J Clin Invest 49: 282–297, 1970.

    Article  PubMed  CAS  Google Scholar 

  36. Reichenbach DD, Benditt EP: Myofibrillar degeneration: A response of the myocardial cell to injury. Arch Physiol 85: 189–199, 1968.

    CAS  Google Scholar 

  37. Reichenbach DD, Benditt EP: Myofibrillar degeneration: A common form of cardiac muscle injury. Ann NY Acad Sci 156: 164–176, 1969.

    Article  PubMed  CAS  Google Scholar 

  38. Schuder JC, Rahmoeller GA: Transthoracic ventricular defibrillation with triangular and trapezoidal waveforms. Circ Res 19: 679–684, 1966.

    Google Scholar 

  39. Schuder JC, Stoeckle H, Gold JH: Effectiveness of transthoracic ventricular defibrillation with square and trapezoidal waveforms. In: Proceedings Purdue Cardiac Defibrillation Conference, Purdue Univ Engineering Experiment Station Document 00147, 109–114, 1975.

    Google Scholar 

  40. Tacker WA, Geddes LA, Cabler PS, Moore AG: Electrical threshold for defibrillation of canine ventricles following myocardial infarction. Am Heart J 88: 476–481, 1974.

    Article  PubMed  Google Scholar 

  41. Tacker WA: Trans-chest ventricular defibrillation of heavy subjects using trapezoidal current waveforms. J Electrocardiol 8: 237–240, 1975.

    Article  PubMed  Google Scholar 

  42. Tonet JL, Baraka M, Nieto J, Frank R, Lilamand M, Fontaine G, Cansell A, Grosgogeat Y: Criteria for induction of chronic complete heart block by His bundle fulguration. JACC 9: 251-A, 1987.

    Google Scholar 

  43. Levy S, Bru P: Interruption Electrique par voie percutanEe de la conduction atrioventriculaire normale. Resultats d’une etude multicentrique francaise. Arch Mal Coeur 79: 1145, 1986.

    PubMed  CAS  Google Scholar 

  44. Scheinman MM, Evans-Bell T: Catheter ablation of the atrioventricular junction: A report of the percutaneous mapping and ablation registry. Circulation 70: 1024–1029, 1984.

    Article  PubMed  CAS  Google Scholar 

  45. Critelli G, Perticone F, Coltorti F, Monda V, Gallagher JJ: Antegrade slow bypass conduction after closed-chest ablation of the His bundle in permanent junctional reciprocating tachycardia. Circulation 67: 687–692, 1983.

    Article  PubMed  CAS  Google Scholar 

  46. Morady F, Scheinman MM, Winston SA, DiCarlo LA, Jr, Davis JC, Griffin JC, Ruder MA, Abbott JA, Eldar M: Transcatheter ablation of posteroseptal accessory pathway. In: Ablation in Cardiac Arrhythmias, G Fontaine, MM Scheinman, eds. Mount Kisco: Futura Publishing Company, 1987, p. 191.

    Google Scholar 

  47. Fisher JD, Brodman R, Kim SG, Matos JA: Nonsurgical kent bundle ablation via the coronary sinus in patients with the WPW syndrome. Circulation 66: (Suppl II); 375, 1982.

    Google Scholar 

  48. Gillette PC, Wampler D, Garson A, Zinner A, Ott DA, Cooley DA: Treatment of atrial automatic tachycardia by ablation procedures. JACC 6: 405–409, 1985.

    PubMed  CAS  Google Scholar 

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© 1988 Martinus Nijhoff Publishing, Boston

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Fontaine, G. (1988). The Effects of High-Energy DC Shocks Delivered to Ventricular Myocardium. 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_5

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  • DOI: https://doi.org/10.1007/978-1-4613-1765-4_5

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-8990-6

  • Online ISBN: 978-1-4613-1765-4

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