scholarly journals Improved Ablation Efficiency in PVI Guided by Contact Force and Local Impedance: Chronic Canine Model

2022 ◽  
Vol 12 ◽  
Author(s):  
Sarah R. Gutbrod ◽  
Allan Shuros ◽  
Vijay Koya ◽  
Michelle Alexander-Curtis ◽  
Lauren Lehn ◽  
...  
Keyword(s):  
Contact Force ◽  
Canine Model ◽  
Tissue Response ◽  
Ablation Procedure ◽  
Ablation Efficiency ◽  
Energy Delivery ◽  
Rf Energy ◽  
Left Pulmonary Vein ◽  
Safety Benefit

Background: The purpose of this study was to assess the effect local impedance (LI) has on an ablation workflow when combined with a contact force (CF) ablation catheter.Methods: Left pulmonary vein isolation was performed in an in vivo canine model (N = 8) using a nominal (30 W) or an elevated (50 W) power strategy with a CF catheter. The catheter was enabled to measure LI prior to and during ablation. LI was visible for only one of the vein isolations.Results: Chronic block was achieved in all animals when assessed 30 ± 5 days post-ablation procedure with a median LI drop during RF ranging from 23.0 to 34.0 Ω. In both power cohorts, the median radiofrequency (RF) duration decreased if LI was visible to the operator (30 W only CF: 17.0 s; 30 W CF + LI: 14.0 s, p = 0.009; 50 W only CF: 6.0 s; 50 W CF + LI: 4.0 s, p = 0.019). An inverse relationship between the LI prior to RF delivery and the RF duration required to achieve an effective lesion was observed. There was no correlation between the magnitude of the applied force and the drop in LI, once at least 5 g was achieved.Conclusions: An elevated power strategy with the context of CF and LI led to the most efficient titration of successful RF energy delivery. The combination of feedback allows for customization of the ablation strategy based on local tissue variation rather than a uniform approach that could potentially lead to overtreatment. Higher LI drops were more readily achievable when an elevated power strategy was utilized, especially in conditions where the catheter was coupled against tissue with low resistivity. Clinical study is warranted to determine if there is an additive safety benefit to visualizing the dynamics of the tissue response to RF energy with LI when an elevated power strategy is used.

P2862Complementary use of contact force and local catheter impedance during RF ablation reduces ablation time in an in vivo swine model

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Garrott ◽  
A Sugrue ◽  
J Laughner ◽  
J Bush ◽  
S Gutbrod ◽  
...  
Keyword(s):  
Real Time ◽  
Contact Force ◽  
Force Sensing ◽  
Swine Model ◽  
Sensitive Information ◽  
Rf Ablation ◽  
Rf Energy ◽  
Force Time

Abstract Catheter-tissue coupling is crucial for effective delivery of radiofrequency (RF) energy during catheter ablation. Force sensing catheters provide a metric of mechanical tissue contact and catheter stability, while local impedance has been shown to provide sensitive information on real-time tissue heating. The complementary use of force and local impedance during RF ablation procedures could provide an advantage over the use of one metric alone. This study evaluates a prototype ablation catheter that measures both contact force (CF) using inductive sensors and local catheter impedance (LI) using only catheter electrodes. The complementary nature was assessed with discrete lesions in vitro and an intercaval line in vivo. A force-sensing catheter with LI was evaluated in explanted swine hearts (n=14) in an in vivo swine model (n=9, 50–70kg) using investigational electroanatomical mapping software. In vitro, discrete lesions were created in ventricular tissue at a range of forces (0–40g) controlled externally. RF energy was applied at a range of powers (20W, 30W, and 40W), durations (10s-60s), and catheter orientations (0°, 45°, and 90°). Lesions were stained with TTC and measured. LI drop relative to baseline during RF in the bench studies was used to inform the in vivo study. In a separate subset of animals in vivo, an intercaval line was created in three experimental groups: LI blinded, 20Ω ΔLI, and 30Ω ΔLI. CF was maintained between 15 and 25g in all groups. All ablations were performed with a power of 30W. In the LI blinded group, all lesions were delivered for 30s. In the 20Ω ΔLI group, the investigator ablated until a 20Ω drop or 30 seconds was achieved. Likewise, in the 30Ω ΔLI, the investigator ablated until a 30Ω drop or 30 seconds was achieved. In vitro, 137 discrete ventricular lesions were created. LI drop during ablation correlated strongly with lesion depth using a monoexponential fit (R=0.84) while force time integral (FTI) did not correlate as strongly (R=0.56). In the intercaval LI blinded group, starting LI ranged from 126–163Ω with a median of 138Ω. LI drops ranged from 13Ω-44Ω, with a median of 26Ω. In the 20Ω ΔLI group, starting LI ranged from 137–211Ω with a median of 161Ω and LI drop ranged from 7Ω-35Ω, with a median of 22Ω. In the 30Ω ΔLI group, starting LI ranged from 130–256Ω with a median of 171Ω and LI drop ranged from 20Ω-52Ω, with a median of 31Ω. Notably, RF time for the LI blinded group was 13±0.1 minutes while RF time in the 20Ω ΔLI group was 6.4±1.9 minutes and 7.5±0.7 minutes in the 30Ω ΔLI group. A catheter incorporating CF-sensing and LI capabilities provides a powerful tool for RF ablation. Bench studies demonstrate a strong correlation between LI drop and lesion dimensions, which guided the use of LI in vivo. In vivo, the confirmation of stable mechanical contact and viewing of real-time LI drops enabled a significant reduction in RF time while creating a continuous intercaval line. Acknowledgement/Funding This study was funded by Boston Scientific.

Comparison of High Purity Factor IX Concentrates and a Prothrombin Complex Concentrate in a Canine Model of Thrombogenicity

1991 ◽  
Vol 66 (05) ◽  
pp. 609-613 ◽  
Author(s):  
I R MacGregor ◽  
J M Ferguson ◽  
L F McLaughlin ◽  
T Burnouf ◽  
C V Prowse
Keyword(s):  
High Purity ◽  
Time Course ◽  
Prothrombin Complex Concentrate ◽  
Degradation Products ◽  
Canine Model ◽  
Factor Ix ◽  
In Vitro Tests ◽  
Albumin Infusion

SummaryA non-stasis canine model of thrombogenicity has been used to evaluate batches of high purity factor IX concentrates from 4 manufacturers and a conventional prothrombin complex concentrate (PCC). Platelets, activated partial thromboplastin time (APTT), fibrinogen, fibrin(ogen) degradation products and fibrinopeptide A (FPA) were monitored before and after infusion of concentrate. Changes in FPA were found to be the most sensitive and reproducible indicator of thrombogenicity after infusion of batches of the PCC at doses of between 60 and 180 IU/kg, with a dose related delayed increase in FPA occurring. Total FPA generated after 100-120 IU/kg of 3 batches of PCC over the 3 h time course was 9-12 times that generated after albumin infusion. In contrast the amounts of FPA generated after 200 IU/kg of the 4 high purity factor IX products were in all cases similar to albumin infusion. It was noted that some batches of high purity concentrates had short NAPTTs indicating that current in vitro tests for potential thrombogenicity may be misleading in predicting the effects of these concentrates in vivo.

The Development of Homologous (Canine/Anti-Canine) Antibodies in Dogs with Haemophilia A (Factor VIII Deficiency): A Ten-Year Longitudinal Study

1993 ◽  
Vol 69 (01) ◽  
pp. 021-024 ◽  
Author(s):  
Shawn Tinlin ◽  
Sandra Webster ◽  
Alan R Giles
Keyword(s):  
Factor Viii ◽  
Canine Model ◽  
Significant Inhibition ◽  
Human Condition ◽  
Haemophilia A ◽  
Variable Expression ◽  
The Family ◽  
Over Time

SummaryThe development of inhibitors to factor VIII in patients with haemophilia A remains as a serious complication of replacement therapy. An apparently analogous condition has been described in a canine model of haemophilia A (Giles et al., Blood 1984; 63:451). These animals and their relatives have now been followed for 10 years. The observation that the propensity for inhibitor development was not related to the ancestral factor VIII gene has been confirmed by the demonstration of vertical transmission through three generations of the segment of the family related to a normal (non-carrier) female that was introduced for breeding purposes. Haemophilic animals unrelated to this animal have not developed functionally significant factor VIII inhibitors despite intensive factor VIII replacement. Two animals have shown occasional laboratory evidence of factor VIII inhibition but this has not been translated into clinical significant inhibition in vivo as assessed by clinical response and F.VIII recovery and survival characteristics. Substantial heterogeneity of inhibitor expression both in vitro and in vivo has been observed between animals and in individual animals over time. Spontaneous loss of inhibitors has been observed without any therapies designed to induce tolerance, etc., being instituted. There is also phenotypic evidence of polyclonality of the immune response with variable expression over time in a given animal. These observations may have relevance to the human condition both in determining the pathogenetic factors involved in this condition and in highlighting the heterogeneity of its expression which suggests the need for caution in the interpretation of the outcome of interventions designed to modulate inhibitor activity.

Leukocyte Adhesion to the Coronary Microvasculature During Ischemia and Reperfusion in an In Vivo Canine Model

Circulation ◽  
1996 ◽  
Vol 93 (10) ◽  
pp. 1784-1787 ◽  
Author(s):  
Frank M. Sheridan ◽  
Paul G. Cole ◽  
David Ramage
Keyword(s):  
Leukocyte Adhesion ◽  
Canine Model ◽  
Ischemia And Reperfusion

Electrospun PLGA and PLGA/gelatin scaffolds for tubularized urethral replacement: Studies in vitro and in vivo

2021 ◽  
pp. 088532822110309
Author(s):  
Jinhua Hu ◽  
Bin Ai ◽  
Shibo Zhu ◽  
Zhen Wang ◽  
Huimin Xia ◽  
...  
Keyword(s):  
Tensile Deformation ◽  
Canine Model ◽  
Urothelial Cells ◽  
Acellular Matrix ◽  
Urethral Strictures ◽  
Acid Copolymer ◽  
Hematoxylin Eosin ◽  
Collagen Tissue

To investigate the biocompatibility of polylactic acid-glycolic acid copolymer (PLGA) and PLGA/gelatin scaffolds and their suitability for tubular urethral replacement in a canine model. PLGA and PLGA/gelatin scaffolds was constructed by electrospinning. Microstructural differences between the scaffolds was examined by Scanning electron microscopy (SEM) followed by mechanical properties testing. Biocompatibility of the material was evaluated using SEM 4, 8, 12 and 72 h after PLGA and PLGA/gelatin scaffolds co-culture with urothelial cells. And confocal analysis was also used to showed the cell adhesive and growth at 12 h. Approximately 2 cm of the anterior urethra of twelve dogs were removed and replaced with a scaffold. After the surgery for 1 month performed urethrography and for 3 month perform hematoxylin–eosin (H&E) and Masson. The results indicated that PLGA and PLGA/gelatin scaffolds had a void microfilament structure, similar to that of normal acellular matrix tissue. And the tensile strength was decreased whereas the tensile deformation and suture retention strength was increased in PLGA/gelatin scaffolds compared to that in PLGA scaffolds Urothelial cells grew well on both scaffolds. Postoperatively, animals recovered well and urinated spontaneously. However, urethrography showed varying degrees of urethral strictures in the reconstructed urethras. H&E and Masson showed that multilayer urothelial cells were formed in both the proximal and distal segments of the reconstructed urethras but without continuity. There was a small amount of smooth muscle and blood vessels under the epithelium, but regenerative urothelial cells at the midpoint of the reconstructed segment did not continue. Lots of lymphocyte infiltration was observed under the epithelium, some collagen tissue was deposited under the neo-urethral epithelium were observed. In conclusion, PLGA and PLGA/gelatin scaffolds are not suitable for tubularized urethral replacement in the canine model.

In vivo behavior of trimethylene carbonate and ε-caprolactone-based (co)polymer networks: Degradation and tissue response

2010 ◽  
Vol 95A (3) ◽  
pp. 940-949 ◽  
Author(s):  
Erhan Bat ◽  
Josée A. Plantinga ◽  
Martin C. Harmsen ◽  
Marja J. A. van Luyn ◽  
Jan Feijen ◽  
...  
Keyword(s):  
Polymer Networks ◽  
Tissue Response ◽  
Trimethylene Carbonate

scholarly journals Improvement of biohistological response of facial implant materials by tantalum surface treatment

2019 ◽  
Vol 41 (1) ◽  
Author(s):  
Mohammed Mousa Bakri ◽  
Sung Ho Lee ◽  
Jong Ho Lee
Keyword(s):  
Foreign Body ◽  
Soft Tissue ◽  
Surface Treatment ◽  
Clinical Applications ◽  
Tissue Response ◽  
Bone Surface ◽  
Tissue Thickness ◽  
Implant Materials ◽  
Soft Tissue Thickness

Abstract Background A compact passive oxide layer can grow on tantalum (Ta). It has been reported that this oxide layer can facilitate bone ingrowth in vivo though the development of bone-like apatite, which promotes hard and soft tissue adhesion. Thus, Ta surface treatment on facial implant materials may improve the tissue response, which could result in less fibrotic encapsulation and make the implant more stable on the bone surface. The purposes of this study were to verify whether surface treatment of facial implant materials using Ta can improve the biohistobiological response and to determine the possibility of potential clinical applications. Methods Two different and commonly used implant materials, silicone and expanded polytetrafluoroethylene (ePTFE), were treated via Ta ion implantation using a Ta sputtering gun. Ta-treated samples were compared with untreated samples using in vitro and in vivo evaluations. Osteoblast (MG-63) and fibroblast (NIH3T3) cell viability with the Ta-treated implant material was assessed, and the tissue response was observed by placing the implants over the rat calvarium (n = 48) for two different lengths of time. Foreign body and inflammatory reactions were observed, and soft tissue thickness between the calvarium and the implant as well as the bone response was measured. Results The treatment of facial implant materials using Ta showed a tendency toward increased fibroblast and osteoblast viability, although this result was not statistically significant. During the in vivo study, both Ta-treated and untreated implants showed similar foreign body reactions. However, the Ta-treated implant materials (silicone and ePTFE) showed a tendency toward better histological features: lower soft tissue thickness between the implant and the underlying calvarium as well as an increase in new bone activity. Conclusion Ta surface treatment using ion implantation on silicone and ePTFE facial implant materials showed the possibility of reducing soft tissue intervention between the calvarium and the implant to make the implant more stable on the bone surface. Although no statistically significant improvement was observed, Ta treatment revealed a tendency toward an improved biohistological response of silicone and ePTFE facial implants. Conclusively, tantalum treatment is beneficial and has the potential for clinical applications.

scholarly journals The Biological Effects of Combining Metals in a Posterior Spinal Implant: In Vivo Model Development Report of the First Two Cases

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Christine L. Farnsworth ◽  
Peter O. Newton ◽  
Eric Breisch ◽  
Michael T. Rohmiller ◽  
Jung Ryul Kim ◽  
...  
Keyword(s):  
Galvanic Corrosion ◽  
Biological Effects ◽  
Model Development ◽  
Spinal Instrumentation ◽  
Pedicle Screws ◽  
Tissue Response ◽  
In Vivo Model ◽  
Particle Count ◽  
Spinal Implant

Study Design. Combinations of metal implants (stainless steel (SS), titanium (Ti), and cobalt chrome (CC)) were placed in porcine spines. After 12 months, tissue response and implant corrosion were compared between mixed and single metal junctions. Objective. Model development and an attempt to determine any detriment of combining different metals in posterior spinal instrumentation. Methods. Yucatan mini-pigs underwent instrumentation over five unfused lumbar levels. A SS rod and a Ti rod were secured with Ti and SS pedicle screws, SS and Ti crosslinks, SS and CC sublaminar wires, and Ti sublaminar cable. The resulting 4 SS/SS, 3 Ti/Ti, and 11 connections between dissimilar metals per animal were studied after 12 months using radiographs, gross observation, and histology (foreign body reaction (FBR), metal particle count, and inflammation analyzed). Results. Two animals had constructs in place for 12 months with no complications. Histology of tissue over SS/SS connections demonstrated 11.1 ± 7.6 FBR cells, 2.1 ± 1.7 metal particles, and moderate to extensive inflammation. Ti/Ti tissue showed 6.3 ± 3.8 FBR cells, 5.2 ± 6.7 particles, and no to extensive inflammation (83% extensive). Tissue over mixed components had 14.1 ± 12.6 FBR cells and 13.4 ± 27.8 particles. Samples surrounding wires/cables versus other combinations demonstrated FBR (12.4 ± 13.5 versus 12.0 ± 9.6 cells, P = 0.96), particles (19.8 ± 32.6 versus 4.3 ± 12.7, P = 0.24), and inflammation (50% versus 75% extensive, P = 0.12). Conclusions. A nonfusion model was developed to study corrosion and analyze biological responses. Although no statistical differences were found in overlying tissue response to single versus mixed metal combinations, galvanic corrosion between differing metals is not ruled out. This pilot study supports further investigation to answer concerns when mixing metals in spinal constructs.

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