Comparative Efficacy of Continuous and Pulsed Argon Laser Ablation of Human Diseased Ventricle

Abstract

We compared the tissue lesions obtained in a saline medium using single continuous argon laser discharges with paired sequential continuous laser discharges in nine segments of diseased human ventricle resected from patients with and without ventricular tachycardia (VT) at cardiac surgery. Single continuous argon laser discharges were delivered to separate sites on the endocardial surface of the tissue segments for periods of 10, 20, and 30 seconds at laser beam power of 5 W (group IA) and 8 W (group IIA). Paired sequential argon laser discharges of 5, 10, and 15 seconds in duration were delivered to separate sites at a laser power of 5 W (group IB) and 8 W (group IIB). Gross and microscopic examination of each tissue lesion and its dimensions were performed. Laser irradiation of excised human ventricle resulted in a circular discrete burn at the site of application. Histologic examination showed crater formation due to tissue vaporization with the crater lining consisting of charred tissue and a zone of coagulation necrosis. Analysis of lesion dimensions in groups IA and IIA showed comparable lesion depth and diameter with single continuous and paired sequential laser discharges at energies of 50 J (p greater than .2), 100 J (p greater than .2), and 150 J (p greater than .2). Similarly, lesion depth and diameter were comparable in groups IB and IIB at the same energies. We conclude that paired sequential argon laser discharges may be used to produce comparable tissue lesions to single continuous argon laser discharges in diseased human ventricle.