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(Circulation. 2004;110:911-914.)
© 2004 American Heart Association, Inc.

Original Articles

ß-Radiation for the Creation of Linear Lesions in the Canine Atrium

Peter G. Guerra, MD; Mario Talajic, MD; Bernard Thibault, MD; Marc Dubuc, MD; Denis Roy, MD; Laurent Macle, MD; Tack Ki Leung, MD; André Arsenault, MD; François Harel, MD; Jean Grégoire, MD; Raoul Bonan, MD

From the Department of Medicine and Research Center (P.G.G., M.T., B.T., M.D., D.R., L.M., R.B.), Pathology (T.K.L.), and Nuclear Medicine (A.A., F.H., J.G.), Montreal Heart Institute, Montreal, Quebec, Canada.

Correspondence to Raoul Bonan and Peter G. Guerra, Montreal Heart Institute, 5000 Belanger East, Montreal, Quebec, Canada H1T 1C8. E-mail raoul.bonan{at}mmic.net or p_guerra@icm-mhi.com

Received April 5, 2004; revision received June 18, 2004; accepted June 28, 2004.

Background— Creating linear lesions is important for the treatment of arrhythmias such as atrial flutter and fibrillation. Making these lesions with standard radiofrequency catheters can be difficult and may result in charring and thrombosis. The purpose of this study was to evaluate ß-radiation as a novel energy source for creating linear myocardial lesions.

Methods and Results— Eight dogs with intact conduction across the cavotricuspid isthmus were studied. The isthmus was irradiated (25 to 50 Gy) with strontium/yttrium-90 delivered via a deflectable 7F catheter (Novoste Corporation). There were no immediate effects, but bidirectional conduction block developed during follow-up studies in 7 of 8 dogs. The dog without conduction block received 25 Gy. After the animals were euthanized, histology revealed transmural, linear areas of fibrosis without any thrombus.

Conclusions— ß-Radiation can safely and effectively create linear lesions that are contiguous and nonthrombogenic. This energy source may become an interesting adjunct to radiofrequency for the treatment of atrial flutter and fibrillation.

Key Words: atrial flutter • catheter ablation • radioisotopes