Closed-Chest Ablation of His Bundle: A New Technique Using Suction Electrode Catheter and DC Shock
The purpose of this paper is to describe a new technique for closed-chest ablation of His bundle. Ten mongrel dogs were generally anesthetized. A bipolare suction electrode catheter was introduced through the femoral vein into the right heart and positioned to the His bundle. When a large His potential appeared, - 100 mmHg suction was applied. In this way the electrode was well fixed on the His bundle. The central terminal of the suction electrode was connected by a switching device to the cathodal output of standard cardioversion unit. A back paddle was positioned adjacent to the left scapula and connected to anodal output of the cardioversion unit. The defibrillator was discharged synchronously with the QRS complex. Using this technique we were able to induce heart block in 9 of 10 dogs by passing an average of 150 J one time through the suction electrode. At the end of the procedure we implanted a used demand pacemaker into the dogs. In 9 of 10 dogs the total AV-Block persisted at the end of the third week. After 3 weeks the dogs were killed and their hearts were investigated histologically.
This technique is an improvement of the method for electric His bundle ablation. Using this method the dislocation of the catheter- which could have serious consequences - can be avoided.
KeywordsComplete Heart Block Catheter Technique Central Terminal Monophasic Action Potential Suction Electrode
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