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Tarantino N, Della Rocca DG, Faggioni M, Zhang XD, Mohanty S, Anannab A, Canpolat U, Ayhan H, Bassiouny M, Sahore A, Aytemir K, Sarcon A, Forleo GB, Lavalle C, Horton RP, Trivedi C, Al-Ahmad A, Romero J, Burkhardt DJ, Gallinghouse JG, Di Biase L, Natale A. Epicardial Ablation Complications. Card Electrophysiol Clin 2020; 12:409-418. [PMID: 32771194 DOI: 10.1016/j.ccep.2020.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The percutaneous epicardial approach has become an adjunctive tool for electrophysiologists to treat disparate cardiac arrhythmias, including accessory pathways, atrial tachycardia, and particularly ventricular tachycardia. This novel technique prompted a strong impulse to perform epicardial access as an alternative strategy for pacing and defibrillation, left atrial appendage exclusion, heart failure with preserved ejection fraction, and genetically engineered tissue delivery. However, because of the incremental risk of major complications compared with stand-alone endocardial ablation, it is still practiced in a limited number of highly experienced centers across the world.
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Affiliation(s)
- Nicola Tarantino
- Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 110 East 210th Street, Bronx, NY 10467, USA
| | - Domenico G Della Rocca
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA.
| | - Michela Faggioni
- Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Xiao-Dong Zhang
- Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 110 East 210th Street, Bronx, NY 10467, USA
| | - Sanghamitra Mohanty
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Alisara Anannab
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Cardiovascular Intervention, Central Chest Institute of Thailand, Nonthaburi, Thailand
| | - Ugur Canpolat
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara 06100, Turkey
| | - Huseyin Ayhan
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Cardiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Mohamed Bassiouny
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Anu Sahore
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Kudret Aytemir
- Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara 06100, Turkey
| | - Annahita Sarcon
- Division of Electrophysiology, University of California San Francisco, San Francisco, CA, USA
| | - Giovanni B Forleo
- Department of Cardiology, Azienda Ospedaliera-Universitaria "Luigi Sacco", Milano, Italy
| | - Carlo Lavalle
- Department of Cardiology, Policlinico Universitario Umberto I, Policlinico Street, Roma 155-00161, Italy
| | - Rodney P Horton
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Chintan Trivedi
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Amin Al-Ahmad
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Jorge Romero
- Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 110 East 210th Street, Bronx, NY 10467, USA
| | - David J Burkhardt
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Joseph G Gallinghouse
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA
| | - Luigi Di Biase
- Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 110 East 210th Street, Bronx, NY 10467, USA; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 919 East 32nd Street, Austin, TX 78705, USA; Interventional Electrophysiology, Scripps Clinic, La Jolla, CA, USA; Department of Cardiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Division of Cardiology, Stanford University, Stanford, CA, USA
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3
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Caluori G, Wojtaszczyk A, Yasin O, Pesl M, Wolf J, Belaskova S, Crha M, Sugrue A, Vaidya VR, Naksuk N, DeSimone CV, Killu AM, Padmanabhan D, Asirvatham SJ, Stárek Z. Comparing the incidence of ventricular arrhythmias during epicardial ablation in swine versus canine models. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2019; 42:862-867. [PMID: 30989679 DOI: 10.1111/pace.13698] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 03/14/2019] [Accepted: 04/11/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Choosing the appropriate animal model for development of novel technologies requires an understanding of anatomy and physiology of these different models. There are little data about the characteristics of different animal models for the study of technologies used for epicardial ablation. We aimed to compare the incidence of ventricular arrhythmias during epicardial radiofrequency ablation between swine and canine models using novel epicardial ablation catheters. METHODS We conducted a retrospective study using data obtained from epicardial ablation experiments performed on swine (Sus Scrofa) and canine (Canis familiaris) models. We compared the incidence of ventricular arrhythmias during ablation between swine and canine using multivariate regression analysis. Six swine and six canine animals underwent successful epicardial radiofrequency ablation. A total of 103 ablation applications were recorded. RESULTS Ventricular arrhythmias requiring cardioversion occurred in 13.11% of radiofrequency ablation applications in swine and 9.75% in canine (relative risk: 117.6%, 95% confidence interval [CI]: 83.97-164.69, animal-based odds ratio [OR]: .55, 95% CI: .23-61.33; P = .184). When adjusting for application position, duration of ablation and power, the odds of developing potentially lethal ventricular arrhythmia in swine increased significantly compared to canine (OR: 3.60, 95% CI: 1.35-9.55; P = .010). CONCLUSIONS The swine myocardium is more susceptible to developing ventricular arrhythmias compared to canine model during epicardial ablation. This issue should be carefully considered in future studies.
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Affiliation(s)
- Guido Caluori
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.,CEITEC, Masaryk University, Brno, Czech Republic
| | - Adam Wojtaszczyk
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.,3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Omar Yasin
- Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
| | - Martin Pesl
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.,First Department of Internal Medicine/Cardioangiology, St. Anne´s Hospital, Masaryk University, Brno, Czech Republic.,Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiří Wolf
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Silvie Belaskova
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Michal Crha
- University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | - Alan Sugrue
- Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
| | - Vaibhav R Vaidya
- Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
| | - Niyada Naksuk
- Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
| | | | - Ammar M Killu
- Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
| | | | - Samuel J Asirvatham
- Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota.,Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Zdeněk Stárek
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.,First Department of Internal Medicine/Cardioangiology, St. Anne´s Hospital, Masaryk University, Brno, Czech Republic
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