Electrical superior vena cava isolation using photodynamic therapy in a canine model

Takehiro Kimura, Seiji Takatsuki, Shunichiro Miyoshi, Mei Takahashi, Emiyu Ogawa, Kazuaki Nakajima, Shin Kashimura, Yoshinori Katsumata, Takahiko Nishiyama, Nobuhiro Nishiyama, Yoko Tanimoto, Yoshiyasu Aizawa, Tsunenori Arai, Keiichi Fukuda

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Abstract

Aims With the new era of multi-tip radiofrequency or balloon ablation catheters replacing the point-to-point ablation strategy, we aimed to determine the feasibility of a ring-laser catheter ablation technology to electrically isolate the superior vena cava (SVC) by exploring the advantages of the limitless catheter tip size possibly with the photodynamic therapy (PDT)-mediated ablation. Methods and results We developed a first-generation prototype of a circular-laser-mapping catheter by fitting a 7 cm plastic optical fibre onto a circular variable-loop Lasso™ mapping catheter. Following SVC venography, both the laser catheter and another ring catheter for monitoring the SVC potentials were placed at the SVC. After the systemic infusion of a photosensitizer (talaporfin sodium), we initiated the irradiation with an output of 1 W in three canines and 0.3 W in four. The creation of electrical isolation as well as occurrence of phrenic nerve injury, sinus node injury, and SVC stenosis were evaluated before, immediately after, and 1 month after the procedure. A PDT-mediated SVC isolation was successfully performed in all seven canines. The isolation was completed with a laser irradiation of 70.4 ± 71.4 J/cm under 30.9 ± 5.0 μg/mL of a photosensitizer without any sinus node injury, phrenic nerve palsy, or SVC stenosis in both the acute and chronic evaluations. The minimum isolation time of 270 s was not correlated with the laser input power or the photosensitizer concentration. Conclusion The electrical SVC isolation was successfully and instantly achieved using the PDT laser-ring catheter without any complications.

Original languageEnglish
Pages (from-to)294-300
Number of pages7
JournalEuropace
Volume18
Issue number2
DOIs
Publication statusPublished - 2016 Feb 1

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Keywords

  • Cardiac catheter ablation
  • Photodynamic therapy
  • Superior vena cava isolation
  • Talaporfin sodium

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Kimura, T., Takatsuki, S., Miyoshi, S., Takahashi, M., Ogawa, E., Nakajima, K., Kashimura, S., Katsumata, Y., Nishiyama, T., Nishiyama, N., Tanimoto, Y., Aizawa, Y., Arai, T., & Fukuda, K. (2016). Electrical superior vena cava isolation using photodynamic therapy in a canine model. Europace, 18(2), 294-300. https://doi.org/10.1093/europace/euv016