Abstract
BackgroundIt is still difficult to create a secure linear conduction block on a beating heart from the epicardial side. To overcome this drawback we developed an infrared coagulator equipped with a cuboid light-guiding quartz rod. This study was designed to electrophysiologically confirm the efficacy of a new ablation probe using infrared energy in a clinical case.MethodsThe infrared light from a lamp is focused into the newly developed cuboid quartz rod, which has a rectangular distal exit-plane that allows 30 mm × 10 mm linear photocoagulation. Two pairs of electrodes were attached to the right atrium of a patient who was undergoing surgery. Each pair of electrodes was placed 10 mm from an ablation line. The change in conduction time between the two pairs of electrodes was measured during ablation. The predicted conduction time delay ratio was 1.54.ResultsThe actual conduction time after ablation was 1.38–1.43 times longer than the pre-ablation conduction time.ConclusionsThe infrared ablation using a newly developed cuboid probe made it possible to create a linear conduction block on the beating right atrial free wall clinically.
Highlights
It is still difficult to create a secure linear conduction block on a beating heart from the epicardial side
To realize the epicardial maze procedure, the major drawback is how to make the transmural lesion on the beating atrial free wall under the condition of existence of inner warm blood flow which weakens heating/cooling effect of the ablation device
We previously reported the fundamental results of using an infrared coagulator in animal models [3,4,5]
Summary
It is still difficult to create a secure linear conduction block on a beating heart from the epicardial side. To overcome this drawback we developed an infrared coagulator equipped with a cuboid light-guiding quartz rod. The newly developed infrared coagulator, named the “Kyo-Co (Photon incorporation, Saitama, Japan)”, contains a reflector that focuses light from a tungsten-halogen lamp into a light-conducting 30 mm × 10 mm cuboid quartz rod, and the light emerges as 35 W/cm of near-infrared light energy (wavelength: 400 nm to approximately 1600 nm; peak wavelength: 850 nm). The distal exit-plane of the light-conducting rod has a rectangular plane surface (30 × 10 mm) (Fig. 1)
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