Coagulation of ventricular myocardium using radiofrequency alternating current: bio-physical aspects and experimental findings. 1989

W Haverkamp, and G Hindricks, and H Gulker, and U Rissel, and W Pfennings, and M Borggrefe, and G Breithardt
Department of Cardiology-Angiology, University Hospital, Münster, Germany, FR.

Within the last years, a variety of different energy sources has been investigated to test their feasibility for catheter ablation of myocardial tissue. This report summarizes our experience of the use of radiofrequency alternating current (500 kHz, unipolar mode) for coagulation of ventricular myocardium in canine experiments. Under standardized in vitro conditions, we found a significant correlation between actually delivered radiofrequency energy and assessed myocardial necrosis (r = 0.87). However, this did not hold for percutaneous application of radiofrequency alternating current to the beating dog heart (r = 0.32). In the intact dog heart, the size of induced lesions paralleled catheter contact pressure which was varied until ST-egment elevation was either 0-2 mV or 5-7 mV. However, no statistical significant differences in either calculated energy or tissue impedance were observed. Under in vivo conditions, a significant improvement in the predictability of the resulting size of lesions was observed when catheter tip temperature, measured via a built-in Ni/CrNi thermoelement, was monitored (r = 0.07). Changes in tip temperature during coagulation also indicated the quality of catheter contact, catheter damage and the appearance of carbonization at the tip of the ablation catheter. Total perforation of the myocardial wall and proarrhythmogenic effects were only rarely observed. In conclusion, catheter coagulation of myocardial tissue using radiofrequency energy can be considered as safe and effective. Since changes in catheter tip temperature occurring during coagulation were found to predict the extent of induced tissue necrosis, the development of temperature controlled radiofrequency devices seems promising and necessary.

UI MeSH Term Description Entries
D009336 Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply.
D011846 Radio Waves Electromagnetic waves with frequencies between about 3 kilohertz (very low frequency - VLF) and 300,000 megahertz (extremely high frequency - EHF). They are used in television and radio broadcasting, land and satellite communications systems, radionavigation, radiolocation, and DIATHERMY. The highest frequency radio waves are MICROWAVES. Hertzian Waves,High Frequency Waves,Radiowave,Radiowaves,Short Waves,Very High Frequency Waves,Frequency Wave, High,Frequency Waves, High,High Frequency Wave,Radio Wave,Short Wave,Wave, High Frequency,Wave, Radio,Wave, Short,Waves, Hertzian,Waves, High Frequency,Waves, Radio,Waves, Short
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D004564 Electrocoagulation Procedures using an electrically heated wire or scalpel to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. It is different from ELECTROSURGERY which is used more for cutting tissue than destroying and in which the patient is part of the electric circuit. Diathermy, Surgical,Electrocautery,Endocavitary Fulguration,Galvanocautery,Surgical Diathermy,Thermocoagulation,Fulguration, Endocavitary
D006352 Heart Ventricles The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation. Cardiac Ventricle,Cardiac Ventricles,Heart Ventricle,Left Ventricle,Right Ventricle,Left Ventricles,Right Ventricles,Ventricle, Cardiac,Ventricle, Heart,Ventricle, Left,Ventricle, Right,Ventricles, Cardiac,Ventricles, Heart,Ventricles, Left,Ventricles, Right
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001145 Arrhythmias, Cardiac Any disturbances of the normal rhythmic beating of the heart or MYOCARDIAL CONTRACTION. Cardiac arrhythmias can be classified by the abnormalities in HEART RATE, disorders of electrical impulse generation, or impulse conduction. Arrhythmia,Arrythmia,Cardiac Arrhythmia,Cardiac Arrhythmias,Cardiac Dysrhythmia,Arrhythmia, Cardiac,Dysrhythmia, Cardiac
D013696 Temperature The property of objects that determines the direction of heat flow when they are placed in direct thermal contact. The temperature is the energy of microscopic motions (vibrational and translational) of the particles of atoms. Temperatures

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