Local repolarization abnormalities induced by transcatheter radiofrequency ablation in pigs

Juan Cinca, Alfons Tapias, Ana Carreño, Mark Warren, Lluís Mont, Pere Blanch, Ana Domingo, J. Soler-Soler

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2 Citations (Scopus)

Abstract

Radiofrequency (RF) ablation alters action potential repolarization of myocardial cells and, theoretically, this should induce ST-T segment changes in the ECG. Since these ECG abnormalities have been rarely reported in patients submitted to RF ablation we assess the ability of the procedure to cause ST-T segment changes in local electrograms. Epicardial ECG mapping was performed in 17 anesthetized open chest pigs submitted to endocardial (n = 9) or to epicardial (n = 8) unipolar radiofrequency ablation (500 kHz, 20 W for 5-10 s). To characterize the cellular electrophysiological alterations induced by RF ablation transmembrane action potentials were recorded at various distances from the ablation lesion; these were compared with seven control pigs. Endocardial RF ablation induced a transient (< 5 min) change of 6.1 ± 2.4 mV in T wave amplitude (baseline: 12.8 ± 5.6 mV, P < 0.001) in 141 out of 269 epicardial electrodes. T wave changes were associated with shortening in local activation time (20.1 ± 2.3 ms at baseline vs 18.5 ± 2.5 ms at 60 s after ablation, P = 0.03). RF current caused persistent ST segment elevation at the center of the ablation lesion with no transmural expansion. Intracellular potentials along a 2-6-mm wide myocardial band bordering the RF lesion showed lower amplitude (101 ± 7.0 mV vs 71 ± 23 mV, P < 0.01) and shorter duration (254 ± 44 ms vs 156 ± 29 ms, P < 0.01) than control hearts. The center of the ablation lesion was electrically unexcitable. We concluded that RF ablation alters cellular electrophysiology in small areas surrounding the ablation lesion and this causes short-lasting transmural changes in T wave amplitude and nontransmural ST segment elevation.
Original languageEnglish
Pages (from-to)1952-1960
JournalPACE - Pacing and Clinical Electrophysiology
Volume20
Issue number8 I
DOIs
Publication statusPublished - 1 Jan 1997

Keywords

  • Cellular electrophysiology
  • ECG mapping
  • Radiofrequency ablation

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