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Published in: BMC Cardiovascular Disorders 1/2014

Open Access 01-12-2014 | Research article

A new method of building permanent A-V block model: ablating his-bundle potential through femoral artery with pre-implanted biventricular pacemaker

Authors: Zheng Cheng, Ye Hai-ge, Li Jin, Ye Wan-chun, Wang Lu-ping, Li Yue-chun, Lin Jia-Feng

Published in: BMC Cardiovascular Disorders | Issue 1/2014

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Abstract

Background

To explore the feasibility of a new method of achieving a permanent A-V block animal model.

Methods

16 beagles were randomly divided into two groups based on the method of their pre-implanted biventricular pacemakers. (1) In the first group (8 beagles), the A-V block model was achieved by ablating his-bundle potential at the site of the left ventricular superior-septum, under the aortic sinus, through femoral artery. (2) In the second group (8 beagles), the A-V block model was achieved by ablating his-bundle potential at the triangle of Koch, through femoral vein. A complete A-V block model was achieved as a standard in this study. The success rates, intraoperative arrhythmias, operative and X-ray exposure time, intraoperative bleeding amount were assessed in this two groups, both animal models were followed up for four weeks and then fasted to monitor myocardial pathological changes.

Results

The success rate of the first group, which with fewer intraoperative arrhythmias, and less operative and X-ray exposure time, was significantly higher than the second group.

Conclusions

Compared with traditional animal method, our new method of ablating his-bundle potential at the left ventricle from the femoral artery has a higher success rate, fewer occurrence of malignant arrhythmias, and less operation and X-ray time. Thus, our new method should be preferred in the building of Permanent A-V Block Model.
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Literature
1.
go back to reference Stockburger M, De Teresa E, Lamas G, Desaga M, Koenig C, Habedank D, Cobo E, Navarro X, Wiegand U: Exercise capacity and N-terminal pro-brain natriuretic peptide levels with biventricular vs. right ventricular pacing for atrioventricular block: results from the PREVENT-HF German Substudy. Europace. 2014, 16 (1): 63-70. 10.1093/europace/eut217.CrossRefPubMed Stockburger M, De Teresa E, Lamas G, Desaga M, Koenig C, Habedank D, Cobo E, Navarro X, Wiegand U: Exercise capacity and N-terminal pro-brain natriuretic peptide levels with biventricular vs. right ventricular pacing for atrioventricular block: results from the PREVENT-HF German Substudy. Europace. 2014, 16 (1): 63-70. 10.1093/europace/eut217.CrossRefPubMed
2.
go back to reference Gonzalez R, Scheinman M, Margaretten W, Rubinstein M: Closed-chest electrode-catheter technique for His bundle ablation in dogs. Am J Physiol. 1981, 241 (2): H283-287.PubMed Gonzalez R, Scheinman M, Margaretten W, Rubinstein M: Closed-chest electrode-catheter technique for His bundle ablation in dogs. Am J Physiol. 1981, 241 (2): H283-287.PubMed
3.
go back to reference Lee YS, Lien WP: Left ventricular approach for recording His bundle potential in man. Chest. 1975, 67 (6): 696-701. 10.1378/chest.67.6.696.CrossRefPubMed Lee YS, Lien WP: Left ventricular approach for recording His bundle potential in man. Chest. 1975, 67 (6): 696-701. 10.1378/chest.67.6.696.CrossRefPubMed
4.
go back to reference Sousa J, El-Atassi R, Rosenheck S, Calkins H, Langberg J, Morady F: Radiofrequency catheter ablation of the atrioventricular junction from the left ventricle. Circulation. 1991, 84 (2): 567-571. 10.1161/01.CIR.84.2.567.CrossRefPubMed Sousa J, El-Atassi R, Rosenheck S, Calkins H, Langberg J, Morady F: Radiofrequency catheter ablation of the atrioventricular junction from the left ventricle. Circulation. 1991, 84 (2): 567-571. 10.1161/01.CIR.84.2.567.CrossRefPubMed
5.
go back to reference Souza O, Gursoy S, Simonis F, Steurer G, Andries E, Brugada P: Right-sided versus left-sided radiofrequency ablation of the His bundle. Pacing Clin Electrophysiol. 1992, 15 (10 Pt 1): 1454-1459.CrossRefPubMed Souza O, Gursoy S, Simonis F, Steurer G, Andries E, Brugada P: Right-sided versus left-sided radiofrequency ablation of the His bundle. Pacing Clin Electrophysiol. 1992, 15 (10 Pt 1): 1454-1459.CrossRefPubMed
6.
go back to reference Fish JM, Di Diego JM, Nesterenko V, Antzelevitch C: Epicardial activation of left ventricular wall prolongs QT interval and transmural dispersion of repolarization: implications for biventricular pacing. Circulation. 2004, 109 (17): 2136-2142. 10.1161/01.CIR.0000127423.75608.A4.CrossRefPubMed Fish JM, Di Diego JM, Nesterenko V, Antzelevitch C: Epicardial activation of left ventricular wall prolongs QT interval and transmural dispersion of repolarization: implications for biventricular pacing. Circulation. 2004, 109 (17): 2136-2142. 10.1161/01.CIR.0000127423.75608.A4.CrossRefPubMed
7.
go back to reference Yan GX, Antzelevitch C: Cellular basis for the normal T wave and the electrocardiographic manifestations of the long-QT syndrome. Circulation. 1998, 98 (18): 1928-1936. 10.1161/01.CIR.98.18.1928.CrossRefPubMed Yan GX, Antzelevitch C: Cellular basis for the normal T wave and the electrocardiographic manifestations of the long-QT syndrome. Circulation. 1998, 98 (18): 1928-1936. 10.1161/01.CIR.98.18.1928.CrossRefPubMed
8.
go back to reference Lubinski A, Lewicka-Nowak E, Kempa M, Baczynska AM, Romanowska I, Swiatecka G: New insight into repolarization abnormalities in patients with congenital long QT syndrome: the increased transmural dispersion of repolarization. Pacing Clin Electrophysiol. 1998, 21 (1 Pt 2): 172-175.CrossRefPubMed Lubinski A, Lewicka-Nowak E, Kempa M, Baczynska AM, Romanowska I, Swiatecka G: New insight into repolarization abnormalities in patients with congenital long QT syndrome: the increased transmural dispersion of repolarization. Pacing Clin Electrophysiol. 1998, 21 (1 Pt 2): 172-175.CrossRefPubMed
9.
go back to reference Tanabe Y, Inagaki M, Kurita T, Nagaya N, Taguchi A, Suyama K, Aihara N, Kamakura S, Sunagawa K, Nakamura K, Ohe T, Towbin JA, Priori SG, Shimizu W: Sympathetic stimulation produces a greater increase in both transmural and spatial dispersion of repolarization in LQT1 than LQT2 forms of congenital long QT syndrome. J Am Coll Cardiol. 2001, 37 (3): 911-919. 10.1016/S0735-1097(00)01200-6.CrossRefPubMed Tanabe Y, Inagaki M, Kurita T, Nagaya N, Taguchi A, Suyama K, Aihara N, Kamakura S, Sunagawa K, Nakamura K, Ohe T, Towbin JA, Priori SG, Shimizu W: Sympathetic stimulation produces a greater increase in both transmural and spatial dispersion of repolarization in LQT1 than LQT2 forms of congenital long QT syndrome. J Am Coll Cardiol. 2001, 37 (3): 911-919. 10.1016/S0735-1097(00)01200-6.CrossRefPubMed
10.
go back to reference Shimizu M, Ino H, Okeie K, Yamaguchi M, Nagata M, Hayashi K, Itoh H, Iwaki T, Oe K, Konno T, Mabuchi H: T-peak to T-end interval may be a better predictor of high-risk patients with hypertrophic cardiomyopathy associated with a cardiac troponin I mutation than QT dispersion. Clin Cardiol. 2002, 25 (7): 335-339. 10.1002/clc.4950250706.CrossRefPubMed Shimizu M, Ino H, Okeie K, Yamaguchi M, Nagata M, Hayashi K, Itoh H, Iwaki T, Oe K, Konno T, Mabuchi H: T-peak to T-end interval may be a better predictor of high-risk patients with hypertrophic cardiomyopathy associated with a cardiac troponin I mutation than QT dispersion. Clin Cardiol. 2002, 25 (7): 335-339. 10.1002/clc.4950250706.CrossRefPubMed
11.
go back to reference Watanabe N, Kobayashi Y, Tanno K, Miyoshi F, Asano T, Kawamura M, Mikami Y, Adachi T, Ryu S, Miyata A, Katagiri T: Transmural dispersion of repolarization and ventricular tachyarrhythmias. J Electrocardiol. 2004, 37 (3): 191-200. 10.1016/j.jelectrocard.2004.02.002.CrossRefPubMed Watanabe N, Kobayashi Y, Tanno K, Miyoshi F, Asano T, Kawamura M, Mikami Y, Adachi T, Ryu S, Miyata A, Katagiri T: Transmural dispersion of repolarization and ventricular tachyarrhythmias. J Electrocardiol. 2004, 37 (3): 191-200. 10.1016/j.jelectrocard.2004.02.002.CrossRefPubMed
12.
go back to reference Salukhe TV, Francis DP, Sutton R: Comparison of medical therapy, pacing and defibrillation in heart failure (COMPANION) trial terminated early; combined biventricular pacemaker-defibrillators reduce all-cause mortality and hospitalization. Int J Cardiol. 2003, 87 (2–3): 119-120.CrossRefPubMed Salukhe TV, Francis DP, Sutton R: Comparison of medical therapy, pacing and defibrillation in heart failure (COMPANION) trial terminated early; combined biventricular pacemaker-defibrillators reduce all-cause mortality and hospitalization. Int J Cardiol. 2003, 87 (2–3): 119-120.CrossRefPubMed
13.
go back to reference Carson P, Anand I, O'Connor C, Jaski B, Steinberg J, Lwin A, Lindenfeld J, Ghali J, Barnet JH, Feldman AM, Bristow MR: Mode of death in advanced heart failure: the Comparison of Medical, Pacing, and Defibrillation Therapies in Heart Failure (COMPANION) trial. J Am Coll Cardiol. 2005, 46 (12): 2329-2334. 10.1016/j.jacc.2005.09.016.CrossRefPubMed Carson P, Anand I, O'Connor C, Jaski B, Steinberg J, Lwin A, Lindenfeld J, Ghali J, Barnet JH, Feldman AM, Bristow MR: Mode of death in advanced heart failure: the Comparison of Medical, Pacing, and Defibrillation Therapies in Heart Failure (COMPANION) trial. J Am Coll Cardiol. 2005, 46 (12): 2329-2334. 10.1016/j.jacc.2005.09.016.CrossRefPubMed
14.
go back to reference Cleland JG, Daubert JC, Erdmann E, Freemantle N, Gras D, Kappenberger L, Tavazzi L: Cardiac resynchronization-heart failure study I: the effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005, 352 (15): 1539-1549. 10.1056/NEJMoa050496.CrossRefPubMed Cleland JG, Daubert JC, Erdmann E, Freemantle N, Gras D, Kappenberger L, Tavazzi L: Cardiac resynchronization-heart failure study I: the effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005, 352 (15): 1539-1549. 10.1056/NEJMoa050496.CrossRefPubMed
15.
go back to reference Pires LA, Abraham WT, Young JB, Johnson KM, Miracle, Investigators M-I: Clinical predictors and timing of New York heart association class improvement with cardiac resynchronization therapy in patients with advanced chronic heart failure: results from the multicenter InSync randomized clinical evaluation (MIRACLE) and multicenter InSync ICD randomized clinical evaluation (MIRACLE-ICD) trials. Am Heart J. 2006, 151 (4): 837-843. 10.1016/j.ahj.2005.06.024.CrossRefPubMed Pires LA, Abraham WT, Young JB, Johnson KM, Miracle, Investigators M-I: Clinical predictors and timing of New York heart association class improvement with cardiac resynchronization therapy in patients with advanced chronic heart failure: results from the multicenter InSync randomized clinical evaluation (MIRACLE) and multicenter InSync ICD randomized clinical evaluation (MIRACLE-ICD) trials. Am Heart J. 2006, 151 (4): 837-843. 10.1016/j.ahj.2005.06.024.CrossRefPubMed
16.
go back to reference Walker S, Levy TM, Rex S, Brant S, Allen J, Ilsley CJ, Paul VE: Usefulness of suppression of ventricular arrhythmia by biventricular pacing in severe congestive cardiac failure. Am J Cardiol. 2000, 86 (2): 231-233. 10.1016/S0002-9149(00)00865-1.CrossRefPubMed Walker S, Levy TM, Rex S, Brant S, Allen J, Ilsley CJ, Paul VE: Usefulness of suppression of ventricular arrhythmia by biventricular pacing in severe congestive cardiac failure. Am J Cardiol. 2000, 86 (2): 231-233. 10.1016/S0002-9149(00)00865-1.CrossRefPubMed
17.
go back to reference Zagrodzky JD, Ramaswamy K, Page RL, Joglar JA, Sheehan CJ, Smith ML, Hamdan MH: Biventricular pacing decreases the inducibility of ventricular tachycardia in patients with ischemic cardiomyopathy. Am J Cardiol. 2001, 87 (10): 1208-1210. 10.1016/S0002-9149(01)01498-9. A1207CrossRefPubMed Zagrodzky JD, Ramaswamy K, Page RL, Joglar JA, Sheehan CJ, Smith ML, Hamdan MH: Biventricular pacing decreases the inducibility of ventricular tachycardia in patients with ischemic cardiomyopathy. Am J Cardiol. 2001, 87 (10): 1208-1210. 10.1016/S0002-9149(01)01498-9. A1207CrossRefPubMed
18.
go back to reference McSwain RL, Schwartz RA, DeLurgio DB, Mera FV, Langberg JJ, Leon AR: The impact of cardiac resynchronization therapy on ventricular tachycardia/fibrillation: an analysis from the combined Contak-CD and InSync-ICD studies. J Cardiovasc Electrophysiol. 2005, 16 (11): 1168-1171. 10.1111/j.1540-8167.2005.40719.x.CrossRefPubMed McSwain RL, Schwartz RA, DeLurgio DB, Mera FV, Langberg JJ, Leon AR: The impact of cardiac resynchronization therapy on ventricular tachycardia/fibrillation: an analysis from the combined Contak-CD and InSync-ICD studies. J Cardiovasc Electrophysiol. 2005, 16 (11): 1168-1171. 10.1111/j.1540-8167.2005.40719.x.CrossRefPubMed
19.
go back to reference Basu Ray I, Fendelander L, Singh JP: Cardiac resynchronization therapy and its potential proarrhythmic effect. Clin Cardiol. 2007, 30 (10): 498-502. 10.1002/clc.17.CrossRefPubMed Basu Ray I, Fendelander L, Singh JP: Cardiac resynchronization therapy and its potential proarrhythmic effect. Clin Cardiol. 2007, 30 (10): 498-502. 10.1002/clc.17.CrossRefPubMed
20.
go back to reference Mykytsey A, Maheshwari P, Dhar G, Razminia M, Zheutlin T, Wang T, Kehoe R: Ventricular tachycardia induced by biventricular pacing in patient with severe ischemic cardiomyopathy. J Cardiovasc Electrophysiol. 2005, 16 (6): 655-658. 10.1111/j.1540-8167.2005.40764.x.CrossRefPubMed Mykytsey A, Maheshwari P, Dhar G, Razminia M, Zheutlin T, Wang T, Kehoe R: Ventricular tachycardia induced by biventricular pacing in patient with severe ischemic cardiomyopathy. J Cardiovasc Electrophysiol. 2005, 16 (6): 655-658. 10.1111/j.1540-8167.2005.40764.x.CrossRefPubMed
21.
go back to reference Medina-Ravell VA, Lankipalli RS, Yan GX, Antzelevitch C, Medina-Malpica NA, Medina-Malpica OA, Droogan C, Kowey PR: Effect of epicardial or biventricular pacing to prolong QT interval and increase transmural dispersion of repolarization: does resynchronization therapy pose a risk for patients predisposed to long QT or torsade de pointes?. Circulation. 2003, 107 (5): 740-746. 10.1161/01.CIR.0000048126.07819.37.CrossRefPubMed Medina-Ravell VA, Lankipalli RS, Yan GX, Antzelevitch C, Medina-Malpica NA, Medina-Malpica OA, Droogan C, Kowey PR: Effect of epicardial or biventricular pacing to prolong QT interval and increase transmural dispersion of repolarization: does resynchronization therapy pose a risk for patients predisposed to long QT or torsade de pointes?. Circulation. 2003, 107 (5): 740-746. 10.1161/01.CIR.0000048126.07819.37.CrossRefPubMed
22.
go back to reference Fish JM, Brugada J, Antzelevitch C: Potential proarrhythmic effects of biventricular pacing. J Am Coll Cardiol. 2005, 46 (12): 2340-2347. 10.1016/j.jacc.2005.08.035.CrossRefPubMedPubMedCentral Fish JM, Brugada J, Antzelevitch C: Potential proarrhythmic effects of biventricular pacing. J Am Coll Cardiol. 2005, 46 (12): 2340-2347. 10.1016/j.jacc.2005.08.035.CrossRefPubMedPubMedCentral
Metadata
Title
A new method of building permanent A-V block model: ablating his-bundle potential through femoral artery with pre-implanted biventricular pacemaker
Authors
Zheng Cheng
Ye Hai-ge
Li Jin
Ye Wan-chun
Wang Lu-ping
Li Yue-chun
Lin Jia-Feng
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2014
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/1471-2261-14-164

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