Percutaneous laser balloon coagulation of accessory pathways

摘要

Abstract: Nonsurgical ablation techniques have been proposed to cease conduction through accessory pathways which electrically connect the atrium and ventricle. The intent of this research was to investigate further the potential use of laser energy, delivered via a balloon catheter in the canine coronary sinus to photocoagulate the myocardial fibers responsible for accessory pathway conduction. Based on histological evaluation of the lesions created in acute and chronic studies, the extent of coagulation necrosis is sufficient to ablate most pathways which lie adjacent to the coronary sinus. Results from surface temperature measurements using repetitive laser exposures suggest that optical and/or thermal changes occurring in the myocardium are of greater importance than those occurring in the adipose tissue. Since the laser balloon catheter is surrounded by various tissue types, a Monte Carlo model was developed to determine the distribution of light in the atrioventricular groove.!