Transcatheter desiccation of the canine left ventricle using radiofrequency energy: a pilot study

Catheter ablation of cardiac tissue by means of direct-current electrical energy is associated with several complications. We assessed the efficacy and safety of closed-chest catheter desiccation of the left ventricular myocardium with microbipolar radiofrequency (RF) energy (750 kHz) in five dogs. The unipolar configuration was used with RF energy delivered between the tip electrode of a standard No. 7F tripolar catheter in the left ventricle and an external patch electrode on the left lateral chest wall. A single application with different RF energy settings (100 J, 200 J, and 300 J) was delivered to three individual endocardial sites of the left ventricle. Ventricular tachycardia or fibrillation was not observed during energy application and 24 hours after ablation, as assessed by a Holter recording. There was no damage to the electrode catheter. Dogs were killed on the fifth day. Pathology showed well-delineated ovoid or round-shaped coagulation necrosis at the ablation sites. Microscopic findings consisted of circumscribed areas of necrosis surrounded by a zone of fibroblastic and mononuclear proliferation. In conclusion, catheter ablation of the ventricular myocardium with RF energy is an apparently safe procedure and can effectively produce discrete areas of injury without destruction of surrounding uninvolved myocardium. This method offers potential clinical utility for catheter ablation of refractory sustained ventricular tachycardia.