Pulmonary Microwave Ablation Near the Heart: Antenna Positioning Can Mitigate Cardiac Complications in a Porcine Model. Radiology 2017 Mar;282(3):892-902
Date
10/13/2016Pubmed ID
27732159Pubmed Central ID
PMC5330302DOI
10.1148/radiol.2016160831Scopus ID
2-s2.0-85013408478 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
Purpose To determine how close to the heart pulmonary microwave ablation can be performed without causing cardiac tissue injury or significant arrhythmia. Materials and Methods The study was performed with approval from the institutional animal care and use committee. Computed tomographic fluoroscopically guided microwave ablation of the lung was performed in 12 swine. Antennas were randomized to either parallel (180° ± 20°) or perpendicular (90° ± 20°) orientation relative to the heart surface and to distances of 0-10 mm from the heart. Ablations were performed at 65 W for 5 minutes or until a significant arrhythmia (asystole, heart block, bradycardia, supraventricular or ventricular tachycardia) developed. Heart tissue was evaluated with vital staining and histologic examination. Data were analyzed with mixed effects logistic regression, receiver operating characteristic curves, and the Fisher exact test. Results Thirty-four pulmonary microwave ablations were performed with the antenna a median distance of 4 mm from the heart in both perpendicular (n = 17) and parallel (n = 17) orientation. Significant arrhythmias developed during six (18%) ablations. Cardiac tissue injury occurred with 17 ablations (50%). Risk of arrhythmia and tissue injury decreased with increasing antenna distance from the heart with both antenna orientations. No cardiac complication occurred with a distance of greater than or equal to 4.4 mm from the heart. The ablation zone extended to the pleural surface adjacent to the heart in 71% of parallel and 17% of perpendicular ablations performed 5-10 mm from the heart. Conclusion Microwave lung ablations performed more than or equal to 5 mm from the heart were associated with a low risk of cardiac complications. © RSNA, 2016.
Author List
Carberry GA, Nocerino E, Mason PJ, Schwahn DJ, Hetzel S, Turnquist AM, Lee FT Jr, Brace CLAuthor
Peter Mason MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Ablation TechniquesAnimals
Disease Models, Animal
Female
Heart
Heart Diseases
Lung
Microwaves
Organs at Risk
Swine
