Experimental efficacy of pericardial instillation of anti-inflammatory agents during percutaneous epicardial catheter ablation to prevent postprocedure pericarditis

Andre D'Avila, Petr Neuzil, Aravinda Thiagalingam, Paulo Gutierrez, Ryan Aleong, Jeremy N. Ruskin, Vivek Y. Reddy

Research output: Contribution to journalArticlepeer-review

74 Scopus citations

Abstract

Prevention of Pericarditis after Epicardial Ablation. Introduction: Pericarditis is a potential complication of catheter-based percutaneous epicardial mapping and ablation. This study evaluates the efficacy and safety of intrapericardial instillation of anti-inflammatory agents after pericardial mapping and ablation in a porcine model of postprocedural pericarditis. Methods and Results: Twenty-five healthy swine underwent epicardial mapping and ablation after transthoracic subxyphoid puncture. After 60 minutes of continuous catheter manipulation in the pericardial space, radiofrequency energy was delivered in a linear fashion to the epicardial surfaces of both atria. The animals were randomly divided to receive the anti-inflammatory agents, Hyaluronic Acid and Triamcinolone, or control. Fourteen days after ablation, the hearts were excised and the degree of pericardial reaction/adhesions scored. The severity was uniformly graded 4 (intense) in all control animals and was characterized by intense adhesion between the parietal and the visceral pericardium obscuring tissue planes and epicardial anatomy. Hyaluronic Acid provided a mild benefit (score 3.0 ± 0.9), but 2 mg/kg of Triamcinolone significantly attenuated the inflammatory effect (all animals uniformly scored 1.0). Conclusion: In a porcine model of ablation-related pericarditis, intrapericardial instillation of 2 mg/kg of intermediate-acting corticosteroids effectively prevents post-procedure inflammatory adhesion formation.

Original languageEnglish
Pages (from-to)1178-1183
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume18
Issue number11
DOIs
StatePublished - Nov 2007
Externally publishedYes

Keywords

  • Catheter ablation
  • Epicardium
  • Pericarditis
  • Radiofrequency

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