ULTRASTRUCTURAL OBSERVATIONS IN THE MYOCARDIUM BEYOND THE REGION OF ACUTE COAGULATION NECROSIS FOLLOWING RADIOFREQUENCY CATHETER ABLATION
ULTRASTRUCTURAL OBSERVATIONS IN THE MYOCARDIUM BEYOND THE REGION OF ACUTE COAGULATION NECROSIS FOLLOWING RADIOFREQUENCY CATHETER ABLATION
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DOI：
10.1111/j.1540-8167.1994.tb01122.x
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发表时间：
1994-10-01
影响因子：
2.7
通讯作者：
HAINES, DE
中科院分区：
文献类型：
--
作者：
NATH, S;REDICK, JA;HAINES, DE
简介：我们假设，射频（RF）导管消融后的心肌损伤可能会超出区域的急性凝固性坏死所定义的histochemical staining.Methods和Results：五个RF病变在体内创建在两只狗的左心室使用4毫米尖端消融电极，其中射频功率进行调整，以保持电极组织界面温度为85摄氏度60秒。将病变一分为二;一半病变用硝基蓝四唑（NBT）染色，另一半进行电子显微镜检查。确定了三个感兴趣区域，从可见的病理病变边界延伸0-3 mm、3-6 mm和> 6 mm。对每个区域的心肌超微结构损伤程度进行评分。电子显微镜检查显示存在显著的质膜、线粒体、肌节、肌浆网和肌细胞间隙连接异常，以及微血管损伤，超出病理病变边缘达6 mm。心肌细胞和微血管的质膜和缝隙连接出现特别敏感的热injury，而闰盘是相对thermalresistant.Conclusion：射频导管消融的结果在超微结构损伤心肌延伸到6毫米以外的急性病理RF病变边界定义的NBT组织化学染色。
Introduction: We hypothesized that myocardial injury following radiofrequency (RF) catheter ablation may extend beyond the region of acute coagulation necrosis as defined by histochemical staining.Methods and Results: Five RF lesions were created in vivo in the left ventricle of two dogs using a 4-mm tipped ablation electrode in which RF power was adjusted to maintain an electrode-tissue interface temperature of 85 degrees C for 60 seconds. The lesions were bisected; one half of the lesions were stained with nitroblue tetrazolium (NBT) and the other half processed for electron microscopy. Three zones of interest were identified extending 0-3 mm, 3-6 mm, and > 6 mm from the visible pathologic lesion border. The degree of ultrastructural injury to the myocardium was scored for each zone. Electron microscopy demonstrated the presence of significant abnormalities of the plasma membrane, mitochondria, sarcomeres, sarcoplasmic reticulum, and gap junctions of myocytes, as well as damage to the microvasculature extending up to 6 mm beyond the pathologic lesion edge. The plasma membrane and gap junctions of myocytes and the microvasculature appeared particularly sensitive to thermal injury, whereas the intercalated discs were relatively thermally resistant.Conclusion: RF catheter ablation results in ultrastructural damage to the myocardium extending up to 6 mm beyond the acute pathologic RF lesion border as defined by NBT histochemical staining.