Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/116794
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Varzaly, J.A. | - |
dc.contributor.author | Chapman, D. | - |
dc.contributor.author | Lau, D.H. | - |
dc.contributor.author | Edwards, S. | - |
dc.contributor.author | Louise, J. | - |
dc.contributor.author | Edwards, J. | - |
dc.contributor.author | Mahajan, R. | - |
dc.contributor.author | Worthington, M. | - |
dc.contributor.author | Sanders, P. | - |
dc.date.issued | 2018 | - |
dc.identifier.citation | Interactive Cardiovascular and Thoracic Surgery, 2018; 28(1):1-9 | - |
dc.identifier.issn | 1569-9293 | - |
dc.identifier.issn | 1569-9285 | - |
dc.identifier.uri | http://hdl.handle.net/2440/116794 | - |
dc.description.abstract | OBJECTIVES: Atrial fibrillation is treated surgically by creating conduction block lesions. Radiofrequency (RF) lesions have reduced efficacy compared to ‘cut-and-sew’. Catheter ablation studies demonstrate a relationship between lesion depth and contact force. We hypothesized that contact force and lesion depth are dependent on design of the bipolar surgical RF clamps. METHODS: Hinged and parallel jaw style RF clamps were studied. Muscle samples were clamped with pressure-sensitive film at increasing tissue thicknesses. Films were analysed determining clamp pressure profiles. A sheep model was utilized for ablation testing using each clamp style until the device indicated transmurality. Separate muscle areas had 1, 2 or 3 burns applied. The muscle was excised, sectioned every 1 cm and stained for lesion depth and fat thickness analysis. RESULTS: Pressure profiling comparing the proximal and distal segments of each clamp style demonstrated only one statistically significant difference in the parallel clamp; the hinged clamp had statistically significant differences (P ≤ 0.03) for all tissue thicknesses. There was no evidence for differences in the proximal lesion depth of both clamps (P = 0.13) but deeper distally in the parallel clamp (10.17 mm vs 8.02 mm, P = 0.003). The logistic regression analysis demonstrated increased odds of transmurality with parallel clamps at 1, 2 or 3 burns (P = 0.03, P = 0.003 and P = 0.002). Every 1 mm increase in overlying fat decreased likelihood of transmurality by 11% (P < 0.05). CONCLUSIONS: The parallel and hinged clamps have different pressure profiles with higher likelihood of transmurality using the parallel clamp. Fat reduces the ability of RF to deliver a transmural lesion. These findings have implications for optimal surgical RF ablation technique. | - |
dc.description.statementofresponsibility | Jason A Varzaly, Darius Chapman, Dennis H Lau, Suzanne Edwards, Jennie Louise, James Edwards, Rajiv Mahajan, Michael Worthington, Prashanthan Sanders | - |
dc.language.iso | en | - |
dc.publisher | Oxford University Press | - |
dc.rights | © The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices) | - |
dc.source.uri | http://dx.doi.org/10.1093/icvts/ivy191 | - |
dc.subject | Surgery; atrial fibrillation; ablation; contact force; lesion; radiofrequency | - |
dc.title | Contact force and ablation assessment of surgical bipolar radiofrequency clamps in the treatment of atrial fibrillation | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1093/icvts/ivy191 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Lau, D.H. [0000-0001-7753-1318] | - |
dc.identifier.orcid | Edwards, S. [0000-0003-2074-1685] | - |
dc.identifier.orcid | Louise, J. [0000-0001-5785-0290] | - |
dc.identifier.orcid | Mahajan, R. [0000-0003-3375-5568] | - |
dc.identifier.orcid | Sanders, P. [0000-0003-3803-8429] | - |
Appears in Collections: | Aurora harvest 8 Medicine publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.