Electrical superior vena cava isolation using photodynamic therapy in a canine model.
Electrical superior vena cava isolation using photodynamic therapy in a canine model.
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在犬模型中使用光动力疗法进行上腔静脉电隔离。
DOI：
10.1093/europace/euv016
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发表时间：
2015
期刊：
影响因子：
6.1
通讯作者：
Fukuda K.
中科院分区：
文献类型：
--
作者：
Kimura T;Takatsuki S;Miyoshi S;Takahashi M;Ogawa E;Nakajima K;Kashimura S;Katsumata Y;Nishiyama T;Nishiyama N;Tanimoto Y;Aizawa Y;Arai T;Fukuda K.
随着多尖端射频或球囊消融导管取代点对点消融策略的新时代，我们旨在通过探索无限导管尖端尺寸的优势，通过光动力治疗（PDT）介导的消融，确定环形激光导管消融技术电隔离上腔静脉（SVC）的可行性。方法和结果我们开发了第一代圆形激光测绘导管的原型，将一根7厘米的塑料光纤安装在圆形可变回路Lasso™测绘导管上。在SVC静脉造影后，在SVC处放置激光导管和另一个用于监测SVC电位的环形导管。在全身输注光敏剂（塔拉波芬钠）后，我们以输出功率为1 W的3只犬和0.3 W的4只犬开始照射。评估电隔离的产生以及膈神经损伤、窦结损伤和SVC狭窄的发生在手术前、手术后立即和手术后1个月。在所有7只犬中成功进行了pdt介导的SVC分离。在光敏剂浓度为30.9±5.0µg/mL、激光照射强度为70.4±71.4 J/cm的情况下完成分离，急性和慢性评估均无鼻窦结损伤、膈神经麻痹或SVC狭窄。最小隔离时间为270 s，与激光输入功率和光敏剂浓度无关。结论采用PDT激光环导管可快速、成功地实现SVC电隔离，无并发症。
AimsWith the new era of multi-tip radiofrequency or balloon ablation catheters replacing the point-to-point ablation strategy, we aimed to determine the feasibility of a ring–laser catheter ablation technology to electrically isolate the superior vena cava (SVC) by exploring the advantages of the limitless catheter tip size possibly with the photodynamic therapy (PDT)-mediated ablation.Methods and resultsWe developed a first-generation prototype of a circular-laser-mapping catheter by fitting a 7 cm plastic optical fibre onto a circular variable-loop Lasso™ mapping catheter. Following SVC venography, both the laser catheter and another ring catheter for monitoring the SVC potentials were placed at the SVC. After the systemic infusion of a photosensitizer (talaporfin sodium), we initiated the irradiation with an output of 1 W in three canines and 0.3 W in four. The creation of electrical isolation as well as occurrence of phrenic nerve injury, sinus node injury, and SVC stenosis were evaluated before, immediately after, and 1 month after the procedure. A PDT-mediated SVC isolation was successfully performed in all seven canines. The isolation was completed with a laser irradiation of 70.4 ± 71.4 J/cm under 30.9 ± 5.0 µg/mL of a photosensitizer without any sinus node injury, phrenic nerve palsy, or SVC stenosis in both the acute and chronic evaluations. The minimum isolation time of 270 s was not correlated with the laser input power or the photosensitizer concentration.ConclusionThe electrical SVC isolation was successfully and instantly achieved using the PDT laser–ring catheter without any complications.