A Symposium Moment

[Guest guest]

Early on, I mentioned that the bulk of the symposium was about ablations and

related information.

Here is some interesting information as to ablation protocols. Prior to

performing the ablation itself. Great care is given to registering/mapping the

location of heart and non heart structures. Such as the mitral valve, aorta,

esophagus and pulmonary veins.

Heat can damage these structures as well as a stray catheter. It's a time

consuming process, buy very necessary. A three dimensional model of the patients

heart is used and these areas are marked off, up to two hundred points, and

monitored for temperature and voltage (PV's). If temperatures exceed a certain

level, in any of these areas, the procedure is delayed or postponed. EP's call.

Temperatures of the radio frequency catheter will run in the 55 to 65 C

degree's range @100watts.

The power is reduced to 55C degree's and 50watts near the posterior wall, to

reduce injury to surrounding structures.

Without to technical, the ablation lines are under constant monitoring for

voltage/impedience. A successful lesion is considered to have taken place when

the local bipolar voltage has been reduced by 80% or less than 0.1mV.

These EP's know their electricity.

After the ablating is done, the lesions are mapped again and checked for

voltage leaks greater than what has been determined to be successful. Blood will

bubble (boil) during the procedure, and great care is given to being sure the

bubbles don't burst. 65 degree's C is approximately 160 degree's F. (double the

celsius and add 30 is a rule of thumb). If any bubbles burst, the power and

temperature are reduced quickly.

A successful PVA is also considered, when they can not induce AF. During this

process, voltage is measured.

That's it for this segment. I have tried to make this as understandable as I

can. The actual process discussed by the EP's themselves is Rocket science.

Rich O