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European Heart Journal 1994 15(7):971-980;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Catheter-directed laser coagulation of atrial myocardium in dogs

H. P. WEBER, A. HEINZE, S. ENDERS*, L. RUPRECHT{dagger} and E. UNSöLD{ddagger}

Laser Unit, 1. Medical Department, Harlaching Hospital Munich
*Institute of Pathology, Bogenhausen Hospital Munich
{dagger}GSF, Laboratory Animal Facilities Oberschleissheim, Germany
{ddagger}GSF, Central Laser Laboratory Oberschleissheim, Germany

Received 22 December 1993; revised 22 February 1994; .

Correspondence: Helmut P. Weber, MD, Kramerstr, 13, D-82061 Neuried, Germany.

Abstract

The feasibility of transcatheter laser coagulation of atrial myocardium was tested in a canine model by using a combined electrode-laser catheter. In 17 anaesthetized beagles a total of 264 lesions, 12–19 per dog, and 3–5 in each area were produced in: (1) the lateral walls, (2) the posterior right atrial walls, (3) the inter-atrial septum, and (4) the atrial appendage. The power source was a continuous wave Nd: YAG laser. Irradiance was 1 kW. cm–2, at a wave length of 1064 nm, the irradiated spot diameter was 2.0–2.5 mm, and the pulse duration 5–60 s. Local intra-cardiac atrial potentials recorded from the targeted areas during laser irradiation dwindled after onset of the laser pulse, and their amplitude was reduced persistently by pulses of 15 s or longer. Histopathologically, the acute lesions showed intramural haemorrhage and coagulation necrosis, but there was no tissue vaporization or crater formation. Chronic lesions showed clear-cut oval-shaped areas of transmural fibrosis. Diameters of lesions, dependent on the amount of laser energy applied, measured from 4.6 ± 0.5 mm (450 J) to 7.8 ±1.4 mm (1800 J). Follow-up lasted 6–25 months (average 10.5). All the animals survived the procedure without complications.

Transcatheter laser coagulation of atrial myocardium is safe and can be performed in a controllable manner by using the catheter system presented.

Key Words: Laser coagulation of atrial myocardium • supraventricular tachycardia • catheter ablation • atrial arrhythmias


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