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IEEE Transactions on Microwave Theory and Techniques
Volume 48 Number 12, December 2000

Table of Contents for this issue

Complete paper in PDF format

Advances in Catheter Ablation for the Treatment of Cardiac Arrhythmias

Arnold J. Greenspon

Page 2670.

Abstract:

RF catheter ablation has become the nonpharmacologic treatment of choice for refractory cardiac arrhythmias. Single carefully directed RF lesions are capable of curing most supraventricular tachycardias. Recent developments in cardiac mapping and lesion formation allow for the analysis and treatment of more complex arrhythmias. Such new technology should help to expand the number of patients successfully treated with catheter ablation.

References

  1. W. M. Jackman, X. Wang and K. J. Friday et al., "Catheter ablation of accessory atrioventricular pathways (Wolff-Parkinson-White syndrome) by radiofrequency current", New Eng. J. Med., vol. 324, pp.  1605-1611, 1991.
  2. M. Schluter, M. Geiger and J. Seibels et al., "Catheter ablation using radiofrequency current to cure symptomatic patients with tachyarrhythmias realted to an accessory atrioventricular pathway", Circulation, vol. 84, pp.  1644 -1661, 1991.
  3. H. Calkins, J. Sousa and S. Rosenheck et al., "Diagnosis and cure of the Wolff-Parkinson-White syndrome or paroxysmal supraventricular tachycardias during a single electrophysiologic test", N. Eng. J. Med., vol. 324, pp.  1612-1618, 1991.
  4. M. D. Lesh, G. F. Van Hare and D. J. Schamp et al., "Curative percutaneous catheter ablation using radiofrequency energy for accessory pathways in all locations: Results in 100 consecutive patients", J. Amer. Coll. Cardiol., vol. 19, pp.  1303-1309, 1992.
  5. W. C. Sealy, B. G. Hattler, S. C. Blumenschein and F. R. Cobb, "Surgical treatment of Wolff-Parkinson-White syndrome", Ann. Thoracic Surg., vol. 8, pp.  1-11, 1969.
  6. M. Eldar, D. G. Ohad, J. J. Goldberger, Z. Rotsteing, S. Hsu, D. K. Swanson and A. J. Greenspon, "Transcutaneous multielectrode basket catheter for endocardial mapping and ablation of ventricular tachycardia in the pig", Circulation, vol. 96, pp.  2430-2437, 1997.
  7. M. Eldar, A. P. Fitzpatrick, D. Ohad, M. F. Smith, S. Hsu, J. G. Whayne, Z. Vered, Z. Rotstein, T. Kordis, M. Chin, M. M. Scheinman, M. D. Lesh and A. J. Greenspon, "Percutaneous multielectrode endocardial mapping during ventricular tachycardia in the swine model", Circulation , vol. 94, pp.  1125-1130, 1996.
  8. A. J. Greenspon, S. S. Hsu, R. Borge, M. F. Smith and M. Eldar, "Insights into the mechanism of sustained ventricular tachycardia after myocardial infarction in a closed-chest porcine model using a multi-electrode basket catheter", J. Cardiovasc. Electrophysiol., vol. 10, pp.  1501-1516, 1999.
  9. A. J. Greenspon, S. S. Hsu and S. Datorre, "Successful radiofrequency catheter ablation of sustained ventricular tachycardia postmyocardial infarction in man guided by a multielectrode basket catheter", J. Cardiovasc. Electrophysiol. , vol. 8, pp.  565-570, 1997.
  10. J. K. Triedman, K. J. Jenkins, S. D. Colan, R. Van Praagh, J. E. Lock and E. P. Walsh, "Multipolar endocardial mapping of the right heart using a basket catheter: Acute and chronic animal studies", Pacing Clin. Electrophysiol., vol. 20, pp.  51 -59, 1997.
  11. C. Schmitt, B. Zrenner and M. Schneider et al., "Clinical experience with a novel multielectrode basket catheter in right atrial tachycardias", Circulation , vol. 99, pp.  2414-2422, 1999.
  12. R. J. Schilling, N. S. Peters and D. W. Davies, "A noncontact catheter for simultaneous endocardial mapping in the human left ventricle: Comparison of contact and reconstructed electrograms during sinus rhythm", Circulation, vol. 98, pp.  887-898, 1998.
  13. N. S. Peters, W. Jackman and R. S. Schilling et al., "Human endocardial activation mapping using a novel noncontact catheter", Circulation, vol. 95, pp.  1658-1660,  1997.
  14. B. Taccardi, G. Arisi and E. Macchi et al., "A new intracavitary probe for detecting the site of origin of ectopic ventricular beats during one cardiac cycle", Circulation, vol. 75, pp.  272-281, 1987.
  15. Y. Rudy and B. J. Messinger-Rapport, "The inverse problem in electrocardiography: Solutions in terms of epicardial potentials", CRC Crit. Rev. Biomed. Eng., vol. 16, pp.  214-268, 1988.
  16. C. C. Gornick, S. W. Adler and FB. Pederson et al., "Validation of a new noncontact catheter system for electroanatomic mapping of left ventricular endocardium", Circulation, vol. 99, pp.  829-835, 1999.
  17. R. J. Schilling, N. S. Peters and D. W. Davies, "Feasibility of a noncontact catheter for endocardial mapping of human ventricular tachycardia", Circulation , vol. 99, pp.  2543-2552, 1999.
  18. L. Gepstein, G. Hayam and S. A. Ben-Haim, "A novel method for nonfluoroscopic catheter-based electroanatomical mapping of the heart: In vitro and in vivo accuracy results", Circulation, vol. 95, pp.  1611-1622, 1997.
  19. S. Shpun, L. Gepstein and G. Hayam et al., "Guidance of radiofrequency endocardial ablation with real-time three-dimensional magnetic navigation", Circulation , vol. 96, pp.  2016-2021, 1997.
  20. L. Gepstien and S. J. Evans, "Electroanatomical mapping of the heart: Basic concepts and implications for the treatment of cardiac arrhythmias", PACE, vol. 21, pp.  1268-1278, 1998.
  21. D. E. Haines and D. D. Watson, "Tissue heating during radiofrequency catheter ablation: A thermodynamic model and observations in isolated perfused and superperfused canine right ventricular free wall", PACE, vol. 12, pp.  962-976, 1989.
  22. R. M. Rosenbaum, A. J. Greenspon, S. S. Hsu, P. Walinsky and A. Rosen, "RF and microwave ablation for the treatment of ventricular tachycardia", in IEEE MMM-S Dig., Atlanta, GA, 1993.
  23. R. M. Rosenbaum, A. J. Greenspon and M. F. Smith et al., "Advanced radiofrequency ablation in canine myocardium", Amer. Heart J., vol. 127, pp.  851-857, 1994.
  24. J. J. Langberg, M. Gallagher, S. A. Strickberger and O. Amirana, "Temperature-guided radiofrequency catheter ablation with very large distal electrodes", Circulation, vol. 88, pp.  245-249, 1993.
  25. S. S. Hsu, L. Hoh, R. M. Rosenbaum, A. Rosen, P. Walinsky and A. J. Greenspon, "A method for the in vitro testing of cardiac ablation catheters", IEEE Trans. Microwave Theory Tech., vol. 44, pp.  1841-1847, 1996.
  26. P. Walinsky, A. Rosen and A. J. Greenspon, "Method and apparatus for high frequency catheter ablation", U.S. Patent 4 641 649,
  27. F. H. Wiffkampf and R. N. Hauer, "Robles de Medina EO: Radiofrequency ablation with a cooled porous electrode catheter", in JACC 1988, vol. 11, abstract,. p.  17. 
  28. H. Nakagawa, W. S. Yamanashi and J. V. Pitha et al., "Comparison of in vivo tissue profile and lesion geometry for radiofrequency ablation with a saline-irrigated electrode versus temperature control in a canine thigh muscle preparation", Circulation, vol. 91, pp.  2264-2273, 1995.
  29. P. Jais, M. Haissaguerre and D. C. Shah et al., "Successful irrigated-tip catheter ablation of atrial flutter resistant to conventional radio frequency ablation", Circulation, vol. 98, pp.  835-838, 1998.
  30. M. Haissaguerre, P. Jais and D. C. Shah et al., "Catheter ablation for atrial fibrillation: Clinical electrophysiology of linear lesions,"in Cardiac Electrophysiology:From Cell to Bedside, D. P. Zipes, and J. Jalife, Eds. 3rd ed.   Philadelphia, PA: W. B. Saunders, 2000, pp.  994-1008.