Objective: Bipolar lesion creation is accepted as the most effective method to create transmural atrial ablations. However, the creation of an ablation pattern on the left and the right atrium with current bipolar devices is difficult on the beating heart. We have evaluated a novel integrated ablation device that creates both bipolar and unipolar lesions in a linear pattern on the beating porcine heart.
Methods: Using six porcine models, we evaluated the effectiveness of creating beating heart ablation lesions by transmurality and conduction block. Isolating lesions were created on the left and right atria of the beating porcine heart. After we created sequential bipolar and unipolar lesions, we confirmed conduction block and examined the lesion depth histologically.
Results: Linear lesions were created successfully on the surface of the beating porcine heart. Conduction block at 20 mV was confirmed at all isolated areas, and 96.4% of the lesion sections had full thickness and were transmural at histology.
Conclusions: This device enables unipolar and bipolar lesion creation in a linear and low-profile manner, enabling effective creation of a biatrial lesion pattern on the epicardial surface of the beating heart.
From the *Division of Cardiothoracic Surgery, Department of Surgery, †UNC Center for Heart and Vascular Care, and ‡Division of Cardiology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC USA.
Accepted for publication November 11, 2013.
Supported by an unrestricted educational grant from Estech, San Ramon, CA USA, to the Advanced Cardiac Arrhythmia Training Institute (ACATI), West End, NC USA. Andy C. Kiser, MD, is a partial owner of ACATI, a training organization, but there was no financial conflict or benefit from this grant.
Presented at the Annual Scientific Meeting of the International Society for Minimally Invasive Cardiothoracic Surgery, June 12–15, 2013, Prague, Czech Republic.
Disclosures: Andy C. Kiser, MD, is a consultant for Karl Storz Endoskope, Tuttlingen, Germany, and Estech, San Ramon, CA USA, and is an owner of ACATI, West End, NC USA. J. Paul Mounsey, BM, BCh, PhD, is a consultant for Medtronic, Inc, Minneapolis, MN USA, and St. Jude Medical, St Paul, MN USA, and has an honorarium relationship with Estech, San Ramon, CA USA, as a member of the speaker’s bureau. Hayden R. Pappas, MD; Kelly C. Garner, ADN, RN; Irion W. Pursell, Jr., BSN, RN; and Anil K. Gehi, MD, MEng, declare no conflicts of interest.
Address correspondence and reprint requests to Andy C. Kiser, MD, Division of Cardiothoracic Surgery, Department of Surgery, University of North Carolina at Chapel Hill, 3040 Burnett-Womack Bldg, CB# 7065, Chapel Hill, NC 27599-7065 USA. E-mail: email@example.com.