Monolith-coated microcentrifuge tubes for the easy extraction of psychoactive substances from urine samples and liquid chromatography-tandem mass spectrometry determination

BACKGROUND

Sample extraction is one of the most critical steps in most of the analytical processes. Nowadays, there is a demand for simple approaches that can effectively extract and concentrate target analytes from complex matrices, like biofluids, with accurate and reliable results.

RESULTS

A porous monolith of poly(methacrylic acid-co-ethylene glycol dimethacrylate) has been immobilized on the inner wall of a 2 mL commercial polypropylene microcentrifuge tube through radical photopolymerization, using bis(2,4,6-trimethylbenzoyl)phenylphosphine oxide as radical initiator and 405 nm laser pointer activation. Photopolymerization parameters were adjusted to obtain a continuous and homogeneous polymer layer (0.16 mm wet polymer thickness and 31 mg dry polymer weight) in the inner tube surface. Extraction efficiency of twelve psychoactive substances was assessed by the evaluation of the effect of sample pH, extraction and desorption times, and desorption solvent volume. Moreover, matrix effect, reusability and stability of monolith-coated microcentrifuge tubes were studied. Sample extracts were measured by liquid chromatography-tandem mass spectrometry, providing limits of quantification (LOQ) from 0.2 to 2.7 μg L-1, recoveries from 80 to 118 %, relative standard deviations lower than 17 %, and a linear range from LOQ to 500 μg L-1.

SIGNIFICANCE

The proposed device is suitable for the easy and simple extraction of psychoactive substances from urine samples with a high portability, reduced solvent consumption, low cost, and low environmental impact.

Biomarkers of exposure in urine of active smokers, non-smokers, and vapers

The exposure to smoking related products has been evaluated through urine illness risk marker determination through the analysis of urine samples of smokers and vapers. Biomarkers and their metabolites such as N-acetyl-S-(2-cyanoethyl)-L-cysteine (CEMA), N-acetyl-S-(3,4-dihydroxybutyl)-L-cysteine (DHBMA), N-acetyl-S-[1-(hydroxymethyl)-2-propen-1-yl)-L-cysteine (MHBMA), N-acetyl-S-(3-hydroxypropyl)-L-cysteine (3HPMA), 2R-N-acetyl-S-(4-hydroxybutan-2-yl)-L-cysteine (HMPMA), and N-acetyl-S-(3-carboxy-2-propyl)-L-cysteine (CMEMA) together with nicotine and cotinine were identified and quantified by LC-HRMS and LC-MS/MS, and data found normalized to the creatinine level. One hundred two urine samples were collected from smokers, non-smokers, and vapers, spanning an age range from 16 to 79 years. Results obtained showed that CEMA was only detected in urine samples from smokers and MHBMA was in the same order of magnitude in all the urine samples analyzed. HMPMA was found in the urine of vapers at the same order of concentration as in non-smokers. 3HPMA in vapers was lower than in the urine of smokers, presenting an intermediate situation between smokers and non-smokers. On the other hand, DHBMA in vapers can reach similar values to those found for smokers, while CMEMA shows concentrations in the urine of vapers higher than in the case of non-smokers and traditional smokers, requiring new research to link this metabolite to the use of electronic cigarettes and possible alternative metabolomic routes. In general, this study seems to verify that traditional smoking practice constitutes a major source of carcinogenic chemicals compared with substitutive practices, although those practices are not free of potential harm.

A green methodology for the determination of cocaine in camouflaged samples

A methodology based on the ultrasound-assisted extraction with ethanol and the dry film attenuated total reflectance infrared spectroscopy (DF-ATR-FTIR) measurement of extracts has been developed for a fast evaluation of non-conventional ("exotic") solid-sized cocaine samples. The method provides quantitative results in less than three minutes with a limit of detection in the solid sample of 1.6 μg g-1 of cocaine with a variation coefficient lower than 7%. Results found for seized samples of different natures were compared with those obtained by a reference gas chromatography method and the greenness of the whole proposed procedure was evaluated and compared using the analytical eco-scale, green analytical procedure index (GAPI), and analytical greenness metric (AGREE). The green evaluation of the proposed methodology provided green scores by considering different evaluation criteria.

Date-rape evidence through fast determination of γ-butyrolactone in adulterated beverages

An infrared spectroscopy (IR) based methodology has been developed to determine γ-butyrolactone (GBL) in adulterated beverages. The proposed method permits the direct screening of GBL in beverages and involves a minimum sample treatment requiring less than 2 min for quantitative determination of GBL. Sensitivity of IR method was improved by using liquid-liquid extraction (LLE) providing detection limits of 0.023 mg g^-1. Accuracy of the proposed methodology was evaluated through the analysis of soft beverages and alcoholic cocktails spiked with GBL at concentration levels ranging from 0.075 to 10 mg g^-1 providing recovery values from 91 to 100%. GBL was determined in twelve blind-spiked beverages, including from mineral water to wine and cocktails. Results obtained were statistically comparable to those provided by a liquid chromatography (LC) reference methodology and consistent with the spiked values. Therefore, the use of LLE-FTIR allowed a simple, sensitive and quantitative determination of GBL in soft beverages and alcoholic cocktails, thus evidencing its use for sex submission intention.

Determination of total phenolic compounds in compost by infrared spectroscopy

Middle and near infrared (MIR and NIR) were applied to determine the total phenolic compounds (TPC) content in compost samples based on models built by using partial least squares (PLS) regression. The multiplicative scatter correction, standard normal variate and first derivative were employed as spectra pretreatment, and the number of latent variable were optimized by leave-one-out cross-validation. The performance of PLS-ATR-MIR and PLS-DR-NIR models was evaluated according to root mean square error of cross validation and prediction (RMSECV and RMSEP), the coefficient of determination for prediction (Rpred(2)) and residual predictive deviation (RPD) being obtained for this latter values of 5.83 and 8.26 for MIR and NIR, respectively.

Direct Determination Methods Without Sample Preparation

The greenest alternatives to the traditional methods of analysis based on sample digestion and/or analyte extraction, are clearly those that permit the direct determination of as many analytes as possible without any sample pretreatment. This chapter deals with the main aspects and applications of remote sensing and teledetection systems, and the use of non-invasive methods of analysis, which permit a direct analysis of samples without any sample damage. In addition, the possibilities offered by several techniques to analyse solids directly without the use of reagents through the direct atomization of small portions of samples, the arc, spark or laser ablation of materials for their analysis by optical emission or mass spectrometry, are evaluated. This chapter attempts to provide a literature survey of all the aforementioned tools which have been evaluated from the perspective of greening analytical practices.

On-line gel permeation chromatography-attenuated total reflectance-Fourier transform infrared determination of lecithin and soybean oil in dietary supplements

Gel permeation chromatography (GPC) with attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectrometry detection has been proposed for the simultaneous determination of lecithin and soybean oil in dietary supplements. The method involves the extraction of analytes with dichloromethane in an ultrasound water bath and the injection of 2 ml of centrifuged and filtered extracts into the system integrated by two Envirogel GPC columns (19 mm x150 mm, 19 mm x 300 mm) coupled on-line. Dichloromethane was used as mobile phase. A method has been developed to select the most appropriated wavenumber to be used for the determination of each considered compound from the calculation of a factor which maximizes the analyte signal minimizing the interferent contributions, being selected the detection wavenumbers of 1034 and 1138 cm(-1) for lecithin and soybean oil, respectively in the first order derivative ATR-FTIR spectra. The method provides limits of detection of 2 and 4 mg ml(-1) for lecithin and soybean oil and repeatability values, measured as relative standard deviation, of 2.5% and 3.4% being extended the linear range till 100 mg ml(-1) for lecithin and up to 50 mg ml(-1) for soybean oil. Accurate results were found for 10 synthetic samples and 7 commercial dietary supplement preparations.

Determination of vinegar acidity by attenuated total reflectance infrared measurements through the use of second-order absorbance-pH matrices and parallel factor analysis

Univariate (zero-order), multivariate (first-order) and multiway (second-order) calibrations were assayed for the determination of vinegar acidity using a mechanized procedure based upon vibrational spectroscopy and the emerging multicommutation methodology. The second-order methodology relies on the use of a flow system based on multicommutation and binary sampling. The flow network comprises a set of three-way solenoid valves, computer-controlled to provide facilities to handle the sample and to generate a time-dependent pH gradient using two carrier solutions. The procedure is based on the volumetric fraction variation approach that maintains the same volume of sample solution and dynamically varies its pH. The analysis of second-order absorbance-pH matrices was performed using parallel factor analysis (PARAFAC). Results were compared with first-order absorbance data analyzed with linear calibration and partial least squares regression (PLS) and they were employed for a discussion of the relative advantages of the applied chemometric tools. As excellent accuracy is obtained without the need of any sample pre-treatment, the procedure can be fully mechanized (i.e., by means of an auto-sampler device). Accuracy of the different strategies assayed was assessed by comparing the results achieved with those obtained by titration reference procedure.

Determination of edible oil parameters by near infrared spectrometry

A chemometric method has been developed for the determination of acidity and peroxide index in edible oils of different types and origins by using near infrared spectroscopy (NIR) measurements. Different methods for selecting the calibration set, after an hierarchical cluster analysis, were applied. After discrimination of olive oils from maize, seed and sunflower, the prediction capabilities of partial least squares (PLS) multivariate calibration of NIR data were evaluated. Several preprocessing alternatives (first derivative, multiplicative scatter correction, vector normalization, constant offset elimination, mean centering and standard normal variate) were investigated by using the root mean square error of validation (RMSEV) and prediction (RMSEP), as control parameters. Under the best conditions studied, the validation set provides RMSEP values of 0.034 and 0.037% (w/w) for acidity in (I) olive oil group and (II) sunflower, seed and maize oils group. RMSEP values for peroxide in both sample groups, expressed as mequiv.O2 kg(-1), were, respectively 1.87 and 0.79. The limit of detection of the methodology developed was 0.03% for acidity in both groups of edible oils (I and II), and 0.9 and 0.8 mequiv.O2 kg(-1) for peroxide in the olive oil and other edible oils groups, respectively. In fact, the methodology developed is proposed for direct acidity quantification and for the screening of peroxide index in edible oils, requiring less than 30 s per sample without any previous treatment.

Separation of motor oils, oily wastes and hydrocarbons from contaminated water by sorption on chrome shavings

In this paper, the ability of chrome shavings to remove motor oils, oily wastes and hydrocarbons from water has been studied. To determine amount of hydrocarbons sorbed on tanned wastes, a FT-NIR methodology was used and a multivariate calibration based on partial least squares (PLS) was employed for data treatment. The light density, porous tanned waste granules float on the surface of water and remove hydrocarbons and oil films. Wastes fibers from tannery industry have high sorption capacity. These tanned solid wastes are capable of absorbing many times their weight in oil or hydrocarbons (6.5-7.6g of oil and 6.3g of hydrocarbons per gram of chrome shavings). The removal efficiency of the pollutants from water is complete. The sorption of pollutants is a quasi-instantaneous process.

Evaluation of nutritional parameters in infant formulas and powdered milk by Raman spectroscopy

It has been made a critical evaluation of the application of near infrared Fourier transform-Raman spectroscopy for the simultaneous determination of the most important nutritional parameters such as energetic value, carbohydrate, protein and fat contents of infant formula and powdered milk samples based on the use of partial least squares (PLS) regression analysis. A highly heterogeneous population of 23 samples, covering a wide range of infant food formula and powdered milk, were obtained from the Spanish market. Raman spectra, obtained by excitation with a Nd:YAG laser at 1064 nm, show no disturbing fluorescence effects; therefore sample spectra can be recorded without any previous preparation step. After correcting the spectra, hierarchical cluster analysis was performed in order to select a representative calibration set and the corresponding validation sample set. Different PLS models and several spectral windows were tested in order to evaluate their prediction capabilities for the validation set. Considering a calibration set comprised of three replicate spectra of 15 samples and a validation data set of eight samples, the procedure developed provided figures of merit which complied with the statutory values declared by the United States Food and Drug Administration (US FDA).

Near-infrared diffuse reflectance spectroscopy and neural networks for measuring nutritional parameters in chocolate samples

A rapid and non-destructive method has been developed for the characterization of chocolate samples based on diffuse reflectance near-infrared Fourier transform spectroscopy (DRIFTS) and artificial neural networks (ANNs). This methodology provides a potentially useful alternative to time-consuming chemical methods of analysis. To assess its utility, 36 chocolate samples purchased from the Spanish market were analyzed for the determination of the main nutritional parameters like carbohydrates, fat, proteins, energetic value and cocoa content. Direct triplicate measurements of each sample were carried out by DRIFTS. Cluster hierarchical analysis was used for selecting calibration and validation data sets, resulting in a calibration set comprised of 19 samples and a validation data set of 17 samples. As it is common the presence of non-linear effect in reflectance spectroscopy, ANNs was chosen for data pretreatment. The root-mean-square error of prediction (RMSEP) values obtained for carbohydrates, fat, energetic value and cocoa were 1.0% (w/w), 1.0% (w/w), 50 kJ (100 g)(-1) and 1.4%, respectively. The mean difference (d(x-y)) and standard deviation of mean differences (s(x-y)) of the carbohydrates, fat, proteins content, energetic value and cocoa content were 0.9 and 2.4% (w/w), 0.2 and 1.0% (w/w), 9.1 and 50 kJ (100 g)(-1), and -0.5 and 1.4%, respectively. The maximum relative error for the prediction (QC) of any of these parameters for a new sample did not exceed 5.2%.

Headspace-mass spectrometry determination of benzene, toluene and the mixture of ethylbenzene and xylene isomers in soil samples using chemometrics

A simple and fast method has been developed for the determination of benzene, toluene and the mixture of ethylbenzene and xylene isomers (BTEX) in soils. Samples were introduced in 10 mL standard glass vials of a headspace (HS) autosampler together with 150 microL of 2,6,10,14-tetramethylpentadecane, heated at 90 degrees C for 10 min and introduced in the mass spectrometer by using a transfer line heated at 250 degrees C as interface. The volatile fraction of samples was directly introduced into the source of the mass spectrometer which was scanned from m/z 75 to 110. A partial least squares (PLS) multivariate calibration approach based on a classical 3(3) calibration model was build with mixtures of benzene, toluene and o-xylene in 2,6,10,14-tetramethylpentadecane for BTEX determination. Results obtained for BTEX analysis by HS-MS in different types of soil samples were comparables to those obtained by the reference HS-GC-MS procedure. So, the developed procedure allowed a fast identification and prediction of BTEX present in the samples without a prior chromatographic separation.

Comparison of two partial least squares infrared spectrometric methods for the quality control of pediculosis lotions

Two vibrational spectroscopy procedures have been developed and compared for the direct and simultaneous determination of piperonyl butoxide and tetramethrin, the active ingredients of alcoholic capillary lotions, for hair pediculosis diseases. Nine lotions, purchased from the Spanish market, were analyzed using both, attenuated total reflectance (ATR) and transmission FT-IR measurements, and based on the use of partial least squares (PLS) multivariate calibration. A reduced set of 15 matched standards (11 for calibration and 4 for validation) was employed using both measurement modes. The spectral wave number ranges between 1757 and 1712 cm(-1) was selected to determine tetramethrin by both, transmittance and reflectance measurements. For the analysis of piperonyl butoxide the 1513-1479 cm(-1) and 1576-1479 cm(-1) regions were selected for ATR and transmission measurements, respectively. Results found for commercial samples compared well with those obtained by a liquid chromatography reference method that evidenced the applicability of the proposed strategy for the analysis of commercial formulations.

Seafood freshness determination through vapour phase Fourier transform infrared spectroscopy

A new vapour-phase manifold has been developed to determine trimethylamine (TMA) in fish and cephalopod samples by Fourier transform infrared (FT-IR) spectroscopy. Samples were treated off-line for 1h with trichloroacetic acid (TCA), filtered and washed. The obtained extracts were aspirated and alkalinized with NaOH 2.0M, in an on-line system. TMA was separated from the solution in a gas phase separator and then transported by means of a nitrogen carrier into a home made 10 cm pathlength IR gas cell, where the corresponding FT-IR spectra were acquired by accumulating 30 scans per spectrum with 2 cm(-1) nominal resolution. The method was applied to the determination of TMA in natural samples providing concentration values statistically comparables with those obtained by a head space gas chromatography (HS-GC) reference procedure. The sample throughput by FT-IR is increased by a factor of 6 as compared with HS-GC.

Evaluation of the application of attenuated total reflectance–Fourier transform infrared spectrometry (ATR–FTIR) and chemometrics to the determination of nutritional parameters of yogurt samples

A critical evaluation of the application of attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR) and partial least squares (PLS) to the determination of several nutritional parameters, such as the energetic value and the carbohydrate, protein and calcium contents, in commercially available yogurt samples was carried out. To this end, a highly heterogeneous population of 48 samples covering a wide range of yogurts obtained from the Spanish market was used. After correcting the spectra, hierarchical cluster analysis was performed in order to select a representative calibration set and the corresponding validation sample set. Different PLS models and several spectral windows were tested in order to evaluate their prediction capabilities for the validation set. For all nutritional parameters, with the exception of fat content, the procedure developed here provided good precision; the values obtained complied with the statutory values declared by the US FDA.

Partial least-squares near-infrared determination of hydrocarbons removed from polluted waters by using tanned solid wastes

A new procedure has been developed for the determination of hydrocarbons retained in solid tanned wastes from polluted waters. The method uses near-infrared (NIR) transmission spectra obtained from leachates of the hydrocarbons with CCl4 using a partial least-squares (PLS) calibration model based on the use of mixtures of n-hexane, isooctane, and toluene diluted with CCl4. This methodology was applied to the evaluation of the absorption capacity of chrome shavings in water samples polluted with hydrocarbons, resulting in a maximum absorption capacity of 6.30 g hydrocarbons per g solid waste.

Determination of nitrogen in hydrolyzed protein formulations by continuous vapour phase FTIR

An on-line system with vapour generation (VG) and Fourier transform infrared (FTIR) spectrometric detection has been developed for the determination of free ammonium and organic nitrogen in agrochemical formulations containing hydrolyzed proteins. Commercial samples were digested, in batch mode, with sulphuric acid and the obtained solution was alkalinized on-line to transform the NH(4)(+) to NH(3) that was continuously monitored by FTIR. Free ammonium was determined in the same system after simple dilution of undigested samples with water. Different gas phase separators were assayed in order to introduce gaseous NH(3) into a home made IR gas cell of 10 cm pathlength, where the corresponding FTIR spectra were acquired by accumulating 10 scans per spectrum. The 967.0 cm(-1) band was used for the quantification of ammonia. The figures of merit of the proposed method involve a linear range up to 100 mg L(-1), a limit of detection (3sigma) of 1.4 mg L(-1) of N, a limit of quantification (10sigma) of 4.8 mg L(-1) of N, a precision (R.S.D.) of 3.0% for 10 replicate determinations of a 10.0 mg L(-1) of N and a sample measurement frequency of 60 h(-1). The method was successfully applied to the determination of free ammonium and total N in commercial amino acid formulations and results compare well with those obtained by the Kjeldhal method.

Determination of insolubles in diesel lubricating oil by FIA-visible spectrometry

Insolubles determination is one of the parameters usually recommended to evaluate the residual life of oil because their presence at elevated levels in diesel lubricating oil changes the viscosity, prematurely clogs filters and is one of the major factors in causing abrasive engine wear. The proposed method employs visible spectrophotometric detection in association with flow injection analysis. The results obtained by this method were compared with the ones obtained by Fourier transform infrared spectrometry (FT-IR) since this is the most employed method for insolubles determination. The proposed method presented a linear response from 0 to 3% (w/w) of insolubles in pentane (ASTM D-893). The sampling frequency was about 30 samplesh(-1), with a relative standard deviation (n=5) of 2.4% or better. Accuracy was evaluated analysing 98 real samples and the results obtained with the FIA-spectrophotometric method were plotted against those obtained by the FT-IR method by means of linear regression. Slope and intercept of the straight line obtained were compared with the theoretical values of 1 and 0 by means of the joint-confidence ellipse F-test. At the confidence level of 95% no evidence of a difference was found between both methods.

Flow injection-FTIR determination of dithiocarbamate pesticides

A flow injection Fourier transform infrared spectrometric procedure has been developed for the determination the dithiocarbamate pesticides Ziram and Thiram in solid samples. All the operations involved, such as extraction, filtration and measurement, were integrated in the experimental set-up in order to avoid excessive manipulation of samples and standards. Ultrasonic assisted and mechanical extraction were evaluated for the solubilization of the analytes and, additionally, the effect of carrier flow rate, sample loop volume and the ratio between sample mass and volume of solvent employed were studied. Quantitative extractions with chloroform were obtained for both Ziram and Thiram, after 5 and 2 min, respectively, of mechanical shaking of sample slurries. Absorbance measurement, in the wavenumber range of 1600-1460 cm-1 for Ziram and 1400-1315 cm-1 for Thiram, was carried out, and the area values of the peaks obtained, as a function of time, were interpolated in external calibration lines prepared from standard solutions of Ziram and Thiram in chloroform. Analyses of commercial formulations and spiked soil samples incubated two weeks were in a good agreement with values found by other methodologies. Absolute detection limits of 400 micrograms for Ziram and 785 micrograms for Thiram and variation coefficients of 6.4% and 2.5% were obtained by use of the aforementioned methodology.

Fourier transform infrared determination of CO2 evolved from carbonate in carbonated apatites

A quantitative method based on FTIR has been developed to determine carbonate in synthetic apatites. The method measures the evolved CO2 after reaction of 50 mg apatite with 2 mL of hydrochloric acid (0.5 M) in a reaction vessel, heated to 40 degrees C. The CO2 evolved was swept by a carrier of nitrogen to a laboratory-made infrared gas cell of 39 mm pathlength and 490 microL volume. The signals were recorded as a function of time and the areas of the chemigram peaks obtained from the measurements in the wavenumber range of 2,500-2,150 cm(-1), were interpolated using a calibration curve. The method can be used to study apatites with carbonate contents below 0.2% with a sampling frequency of 8 h(-1).

Fourier transform infrared determination of caffeine in roasted coffee samples

A new procedure has been developed for the FT-IR determination of caffeine in roasted coffee samples. The method involves wetting the coffee samples with a 0.25 M aqueous NH3 solution, extracting the caffeine with CHCl3, and measuring absorbance at 1,659 cm(-1) using a baseline established between 1,900 and 830 cm(-1). The procedure proposed is fast, only requiring a total extraction time of 16 min for each sample, and provides a drastic reduction of the organic solvent consumed, from the 200 mL diethyl ether and 50 mL CHCl3, required for each sample by the reference chromatographic UV-spectrometric determination to only 5 mL CHCl3. The method provides a limit of detection of the order of 3 mg L(-1) caffeine and a relative standard deviation of 0.4% for 3 independent analyses of a sample containing 18.6%mg/g caffeine. The accuracy of the FT-IR procedure was evaluated from recovery experiments on spiked samples providing values from 94.4 to 100.1% and from the comparison of results found for a series of commercial samples, by both FT-IR and the official reference procedure.

Flow injection Fourier transform infrared determination of nicotine in tobacco

A fully automated procedure is proposed for the Fourier transform infrared (FTIR) determination of nicotine in tobacco. The method is based on the on-line extraction of nicotine with CHCl3. Samples, weighed inside empty extraction cartridges, were humidified with NH3 and the cartridges were installed in a flow manifold in which they were extracted with 2 ml CHCl3 for 2 min, then 400 microliters of the extract were introduced into a micro-flow cell using a carrier of CHCl3 and the IR spectrum was registered continuously. The absorbance, in the wavenumber range 1334-1300 cm-1, was measured, obtaining a peak as a function of time. The area of this peak was interpolated on a calibration line established from standard solutions of nicotine in chloroform treated in the same way as samples. The method provided a limit of detection of 0.1 mg ml-1 nicotine, an RSD lower than 2% and a sampling frequency of the whole procedure of 6 h-1. Results obtained for natural samples of cut tobacco and cigar compared well with those obtained by a batch FTIR procedure, involving an off-line extraction with a total time of 16 min. However, for yellow tobacco cigarette, an on-line extraction time of 10 min was required to obtain a good recovery of nicotine.

Clean method for the simultaneous determination of propyphenazone and caffeine in pharmaceuticals by flow injection Fourier transform infrared spectrometry

A procedure is proposed for the simultaneous FTIR determination of propyphenazone (PFZ) and caffeine (CAF) in pharmaceuticals. The method involves the dissolution of the active principles in CHCl3, followed by filtration of sample solutions to remove the excipients. PFZ is then determined by absorbance measurements at 1595 cm-1, using a baseline established between 2000 and 890 cm-1, and CAF by using the first-derivative values at 1712 cm-1, using solutions of PFZ and CAF for external calibration. The method was applied in both the stopped-flow and flow-injection modes, providing precise and accurate results for the analysis of real samples. The incorporation of a distillation unit for the on-line recycling of the CHCl3 used as carrier and solvent provides an environmentally friendly analytical methodology which makes possible an injection frequency of 120 samples h-1 and reduces the cost and side-effects of the production of laboratory waste.

Right and left atrial radiofrequency catheter therapy of paroxysmal atrial fibrillation

INTRODUCTION

Atrial fibrillation (AF), the most common arrhythmia, is due to multiple simultaneous wavelets of reentry in the atria. The only available curative treatment is surgical, using atriotomies to compartmentalize the atria. Therefore, we investigated a staged anatomical approach using radiofrequency catheter ablation lines to prevent paroxysmal AF.

METHODS AND RESULTS

Forty-five patients with frequent symptomatic drug-refractory episodes of paroxysmal AF were studied. Progressively complex linear lesions were created by sequential applications of radiofrequency current in the right atrium and then in the left atrium if required. The outcome of the procedure was considered a success when the episodes of AF were either eliminated or recurred at a rate of no more than one episode (lasting < 6 hours) in 3 months. Patients who had no more than one episode per month were considered "improved." Right atrial ablation organized local electrical activity and led to stable sinus rhythm during the procedure in 18 (40%) of the 45 patients. However, sustained AF remained inducible in 40 of 45 patients, and the lesions failed to produce evidence of a significant linear conduction block/delay in all but four patients. There were no significant complications except for two transient sinus node dysfunctions. The procedure duration and fluoroscopic time were 248 +/- 79 and 53 +/- 22 min, respectively. Additional sessions were required in 19 patients to treat sustained right atrial flutter or arrhythmias linked to ectopic right or left atrial foci. During a mean follow-up of 11 +/- 4 months, right atrial ablation was successful in 15 (33%) patients, 6 without medication and 9 with a previously ineffective drug. Nine (20%) additional patients were improved. Ten patients with an unsuccessful outcome then underwent linear ablation in the left atrium. The procedure duration and fluoroscopy time were 292 +/- 94 and 66 +/- 24 min. A hemopericardium occurred in one patient. Two patients required reablation to treat ectopic atrial foci. Left atrial ablation terminated AF during the procedure in 8 patients, and sustained AF could not be induced in 5. Subsequent success was achieved in 6 (60%) patients, including 4 without medication, and 1 additional patient was improved.

CONCLUSIONS

Successful radiofrequency catheter ablation of drug-refractory daily paroxysmal AF is feasible using linear atrial lesions complemented by focal ablation targeted at arrhythmogenic foci. Ablation only in the right atrium is a safe technique providing limited success, whereas linear lesions in the left atrium significantly increase the incidence of stable restoration of sinus rhythm, the inability to induce sustained AF, and the final success rate. The described technique is promising but must be considered preliminary because significant improvements are required to optimize lesion characteristics and shorten total procedure duration.

Radiofrequency catheter ablation of common atrial flutter in 200 patients

INTRODUCTION

The purpose of this study was to evaluate the efficacy and safety of radiofrequency (RF) catheter ablation of common atrial flutter and to determine the optimum target sites in a large series of patients. Three different approaches were used to target the ablation site. The first used a combined anatomic and electrophysiologic approach, whereas the second and the third approaches relied primarily on anatomic guidelines to target the critical area in the atrial flutter reentrant circuit located in the low right atrium.

BACKGROUND

Recent studies report the efficacy of RF current application in the low right atrial region to interrupt and prevent recurrences of common atrial flutter using either anatomic or electrophysiologic targets. However, larger groups of patients are required to confirm the efficacy of this technique and to specify the target sites.

METHODS AND RESULTS

Two hundred consecutive patients with drug-resistant common atrial flutter were studied. In the first 50 patients, target sites were localized using both anatomic landmarks and electrophysiologic parameters. The anatomic landmarks were area 1 between the tricuspid valve and inferior vena cava orifice; area 2 between the tricuspid valve and coronary sinus ostium; and area 3 between the inferior vena and coronary sinus. The electrophysiologic criterion was to ablate when there was an atrial electrogram occurring during the plateau phase (preceding F wave). The first targeted area was that giving the more stable catheter position. In the following 30 patients, we assessed the effect of RF energy application in a single line to area 1 in the first 10 patients, area 2 in the next 10, and area 3 in the last 10 patients. In the last 120 patients, RF energy was applied only in area 1 using repeated applications. RF energy of 12 to 30 W, or that achieving a temperature of 70 degrees C, was applied for 60 to 90 seconds at each site. The endpoint of the ablation procedure was interruption and noninducibility of common atrial flutter in the first 110 patients and additional isthmal block in 48 of the last 90 patients. Overall, atrial flutter was interrupted and rendered noninducible after a single session in 191 (95%) patients and could not be interrupted in 9 (4.5%) patients. The mean number of RF applications was 12 +/- 8. After a mean follow-up of 24 +/- 9 months, recurrences occurred in 31 (15.5%) patients, 26 of whom underwent a successful second or third session without further recurrences of atrial flutter. Atrial fibrillation not documented before the ablation was detected in 11 patients. On a retrospective analysis of the final successful site in the first group of 50 patients, the location was in area 1 in 39% of patients; area 2 in 36% of patients, and area 3 in 25% of patients. Atrial electrograms recorded at these sites showed a single spike pattern in 46% of patients, and double spike pattern (28%) or fractioned electrogram in 26% patients. When lines of RF lesions were placed at several sites, they produced a success rate of 70%, 40%, and 10% at areas 1, 2, and 3 respectively. In the last series of 120 patients, the procedure was successful in 119 patients: 92% of whom were successfully treated only by a linear lesion between the tricuspid annulus isthmus and the inferior vena cava, and the other 8% by additional applications near the coronary sinus ostium. No complications were observed.

CONCLUSIONS

RF catheter ablation of atrial flutter can be done with a high success rate and is safe. The highest success rate is achieved with RF energy applied in the isthmus between the inferior vena cava orifice and the tricuspid valve. However, 15.5% of patients need multiple sessions to achieve success because of recurrence of flutter. Further follow-up is needed to evaluate the long-term effects of this procedure.

Radiofrequency catheter ablation of common atrial flutter in 80 patients

OBJECTIVES

The purpose of this study was to evaluate the efficacy and safety of radiofrequency catheter ablation of common atrial flutter and to determine the optimal target sites in a large series of patients.

BACKGROUND

Recent studies report the efficacy of radiofrequency current application in the low right atrial region to interrupt and prevent recurrences of common atrial flutter. However, larger groups of patients are required to confirm the efficacy of this technique and to specify the target sites.

METHODS

Two different approaches were used to target the ablation site in 80 consecutive patients. In the first 50 patients, target sites were localized using both anatomic landmarks and electrophysiologic variables. Three anatomic landmarks were used: area 1 = between the tricuspid valve and inferior vena cava orifice; area 2 = between the tricuspid valve and coronary sinus ostium; area 3 = between the inferior vena cava and coronary sinus. The electrophysiologic criterion was to ablate when there was a stable atrial electrogram during the plateau phase. In the next 30 patients we assessed the effect of application of radiofrequency energy in a single line in area 1, 2 or 3 in groups of 10 patients.

RESULTS

Overall atrial flutter was interrupted and rendered noninducible after a single session in 72 patients (90%) and could not be interrupted in 8 (10%). The mean (+/- SD) number of radiofrequency applications was 12 +/- 8. After a mean (+/- SD) follow-up of 20 +/- 8 months, recurrences occurred in 14 patients (17%). The location of the final successful site in the first group of 50 patients was in area 1 in 39%, area 2 in 36% and area 3 in 25%. In the next 30 patients, when lines of radiofrequency lesions were placed at several sites, they produced success rates of 70%, 40% and 10% at areas 1, 2 and 3, respectively.

CONCLUSIONS

Radiofrequency catheter ablation of atrial flutter can be performed with a high success rate and is safe. The highest success rate is achieved with radiofrequency energy applied in the isthmus between the inferior vena cava orifice and tricuspid valve.