From the Cardiovascular Division, Department of Internal Medicine,
University of Virginia Health Sciences Center, Charlottesville.
Correspondence to David E. Haines, MD, Box 158, Cardiovascular Division, University of Virginia Health Sciences Center, Charlottesville, VA 22908. E-mail dhaines{at}virginia.edu
Background—To test the hypothesis
that susceptibility to sustained atrial fibrillation may be decreased
by creation of linear atrial ablations, we established a canine model
of chronic atrial fibrillation and used a novel catheter design to
create atrial ablations.
Methods and Results—Chronic atrial fibrillation was induced in 16
dogs by creation of mitral regurgitation and rapid
pacing of the atria. Temperature-controlled radiofrequency ablations
were attempted along empirically derived, preselected atrial target
sites in 11 dogs (ablation group), and a sham procedure was performed
in 5 dogs (control group). Follow-up electrophysiology study and
pathological examination were conducted 13±5 days after the initial
procedure. Immediately after ablation, sustained atrial fibrillation
could be initiated in 1 of 9 surviving ablation dogs and 5 of 5
controls (P=.004). Four dogs died within 24 hours of the
procedure. Permanent pacing was required in 4 dogs. At follow-up, 0 of
7 ablation dogs and 5 of 5 controls had atrial fibrillation
(P=.001). Furthermore, 2 of 7 ablation dogs had
sustained atrial tachycardias, one of which was
successfully ablated. Pathological examination demonstrated frequent
incomplete lesion sets and discontinuous lesions.
Conclusions—In this model, a reduction in the susceptibility to
sustained atrial fibrillation can be achieved by long linear atrial
ablations created with specially designed coil electrode catheters.
Complete lesion continuity was not required to achieve a therapeutic
effect.
© 1998 American Heart Association, Inc.
Basic Science Reports
Linear Atrial Ablations in a Canine Model of Chronic Atrial Fibrillation
Morphological and Electrophysiological Observations
Key Words: catheter ablation • arrhythmia • atrium • electrophysiology • fibrillation
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