Nonthermal cardiac catheter ablation using photodynamic therapy

Takehiro Kimura, Seiji Takatsuki, Shunichiro Miyoshi, Kotaro Fukumoto, Mei Takahashi, Emiyu Ogawa, Arisa Ito, Tsunenori Arai, Satoshi Ogawa, Keiichi Fukuda

Research output: Contribution to journalArticlepeer-review

40 Citations (Scopus)

Abstract

Background: Radiofrequency ablation has limitations, largely related to creation of lesions by heating. Here, we report the first nonthermal ablation by applying photodynamic therapy (PDT) to cardiac tissues using a custom-made deflectable laser catheter. The present study investigated the feasibility of PDT for cavotricuspid isthmus ablation in a canine model. Methods and Results: We evaluated the pharmacokinetic profiles of 17 canines after administration of a photosensitizer (talaporfin sodium) by various protocols. We succeeded in maintaining the photosensitizer concentration at a level in excess of the clinically effective dose for humans. Using a 4-polar 7-French deflectable laser catheter, we performed PDT-mediated cavotricuspid isthmus ablation in 8 canines. PDT caused oxidative injury only to the irradiated area and successfully produced a persistent electric conduction block. No acute, gross changes such as edematous degeneration, thrombus formation, steam pops, or traumatic injury were observed after irradiation. Hematoxylin and eosin staining of tissues samples also showed well-preserved endothelial layers. Testing of the blood samples taken before and after the procedure revealed no remarkable changes. Lesion size at 2 weeks after the procedure and the temperature data collected during irradiation were compared between the PDT and irrigated radiofrequency ablation procedures. A ventricular crosssection revealed a solid PDT lesion, which was as deep as a radiofrequency lesion. In addition, endocardial, surficial, and intramural temperature monitoring during the PDT irradiation clearly demonstrated the nonthermal nature of the ablation technique. Conclusions: Nonthermal PDT-mediated catheter ablation is a potentially novel treatment for cardiac arrhythmias.

Original languageEnglish
Pages (from-to)1025-1031
Number of pages7
JournalCirculation: Arrhythmia and Electrophysiology
Volume6
Issue number5
DOIs
Publication statusPublished - 2013 Oct

Keywords

  • Atrial flutter
  • Catheter ablation
  • Photochemotherapy
  • Talaporfin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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