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Biomedical subjects

Y Enjoji

Publications and source records attributed to Y Enjoji.

28 records · Page 2Linked to original sources

[An experimental study of catheter ablation using microwave energy via coaxial electrode catheter].

The purpose of this study was to examine the efficacy, arrhythmogenicity, and the size of ablated lesions of catheter ablation with microwave energy. Microwave energy generated by a device with a frequency of 2450 MHz, was delivered via a bipolar electrode coaxial catheter with an electrode ball tip. Microwave ablation was applied (50 watts for 15-150 sec.) on the left ventricular endocardium in 6 dogs. No ventricular arrhythmia occurred during ablation in any of the dogs when microwave catheter ablation was applied for less than 45 sec. However, when the duration of microwave catheter ablation was longer than 45-60 sec, ventricular premature contractions were observed in all 6 dogs. When ablation time was set for a longer time, the dogs developed nonsustained ventricular tachycardias. Nevertheless, ventricular arrhythmias after ablation did not occur in all dogs. Ventricular programmed stimulation after ablation did not induce ventricular tachycardia in any of the dogs. When ablation time lasted more than 120 sec, the coagulation layer was extended to the epicardium in all 6 dogs. The results of this study suggest that microwave ablation is feasible for the treatment of tachyarrhythmias from a deep focus of the ventricular myocardium.

Animals↗

[An experimental study on transcoronary chemical ablation: comparison of ventricular tachyarrhythmias induced by chemical ablation according to different chemical materials].

The purpose of this study was to compare heart rate, appearance rate and duration of ventricular tachycardia (VT) by transcoronary chemical ablation using 95% ethanol and 1% aethoxysclerol respectively. After the balloon which was guided to the left or right coronary artery with PTCA technique in anesthetized dogs was inflated, chemical ablation was performed using ethanol (n = 5) or aethoxysclerol (n = 5). These chemicals were administered at 0.05 ml/sec with total dose of 0.50-1.50 ml. A quadripolar electrode catheter was used to record the intracardiac electrogram. VT occurred in all dogs (100%) after the administration of both ethanol and aethoxysclerol. In one dog using ethanol, VT developed into ventricular fibrillation, resulting in death. In dogs using aethoxysclerol, the heart rate and duration of VT were significantly lower and shorter than in those using ethanol (p < 0.05). There were no significant differences determined histologically in the ablated lesions caused by these different chemicals. We conclude that the severity of VT induced in all subjects by chemical ablation is different according to the materials applied, and that aethoxysclerol seems to be safer in comparison with ethanol.

Animals↗

[The influence of repetitive delivery of radiofrequency current in catheter ablation].

The single delivery of radiofrequency current to the cardiac tissue can produce discrete small and shallow area of homogeneous coagulation necrosis. Little is known, however, concerning the influence of repetitive deliveries of radiofrequency current to the identical site of the ventricular myocardium. Therefore, in animal experiments using 8 dogs, we investigated the influences of those applications on the ventricular myocardium from the histological and electrocardiographical aspects. The used frequencies of radiofrequency current were 13.56 MHz (RF-50), 520 kHz (Hatt 200 S) and 500 kHz (LL-50). Released power was 25 Watts in current and 20 seconds in duration. The innings of application were 10, 20 and 30 times per one ablation session. The depth of ablated lesion became greater as the applied innings increased in any generator of radiofrequency current. The ablated lesion by the delivery over 20 times reached from the ventricular endocardium to the epicardium. In contrast, surface area produced by repetitive application was determined by the size and length of the tip of electrode catheter. T wave inversion and isolated premature ventricular contraction on electrocardiogram were observed only during repetitive radiofrequency energy application. Thus, since the repetitive delivery of radiofrequency energy to the identical myocardium caused the deep ablated lesion reached to the epicardium, caution should be taken against myocardial perforation in a clinical setting. However, this application could be useful for the ablation of deeper lesion responsible for ventricular tachycardia.

Animals↗

[An experimental study of determining the appropriate frequency of radiofrequency catheter ablation in vitro and in vivo for ventricular tachycardias].

The purpose of this study was to examine the appropriate frequency of radiofrequency catheter ablation (RFA) for ventricular tachycardia. Radiofrequency energy generated by a device in which the frequency could be changed, was delivered from an electrode catheter with an electrode tip-width of 4 mm. RFA was performed for 10 seconds with 20W (50V x 0.4A) using 7 different frequencies from 10 to 500 kHz on ventricular myocardium in vitro and in anesthetized dogs. The ablated lesion was significantly larger with RFA of 200-300 kHz in both surface area and depth (p less than 0.05). The appearance of ventricular arrhythmia during RFA increased as the frequency decreased, and one dog applied with RFA of 100 kHz had spontaneous ventricular fibrillation resulting in death. All dogs with frequency less than 100 kHz had a muscle cramp during RFA. We conclude that appropriate frequency seems to be 200-300 kHz to obtain a large ablated lesion, and a frequency higher than 300 kHz seems suitable to avoid arrhythmia. We also conclude that a frequency under 100 kHz should not be used.

Animals↗

[A clinical study of induction rate of atrioventricular reciprocating tachycardia in WPW syndrome].

The differences in induction rate of atrioventricular reciprocating tachycardia (AVRT) were analyzed in 76 consecutive patients of WPW syndrome with tachycardia attack, confirmed by either ECG or history, and who underwent electrophysiological study. AVRT was induced by programed electrical stimulation in 72% of patients with manifest WPW syndrome, in 77% of patients with intermittent WPW syndrome, and in 96% of patients with concealed WPW syndrome, respectively. There was a significant difference in induction rate between manifest WPW syndrome and concealed WPW syndrome (p less than 0.05). Induction rate of AVRT in patients with accessory pathway (AP) located in the ventricular septum was significantly lower (50%) than in patients with AP located in the left ventricle (88%) and in the right ventricle (72%) (p less than 0.05). Ventricular atrial conduction was found in only 56% of patients with AP located in the ventricular septum, while it was found in 94% of patients with AP located in the left ventricle, and in 100% of patients with AP located in the right ventricle (p less than 0.05). There were no significant differences in antegrade effective refractory periods of atrioventricular node and AP between patients with and without inducible AVRT. There was also no significant difference in the retrograde effective refractory periods of AP between patients with or without inducible AVRT. We concluded that the induction rate of AVRT would be affected by the location of AP and the mode of delta wave appearance in the surface electrocardiogram.

Adult↗

[Is radiofrequency catheter ablation available for treatment of ventricular tachycardias?--Effects of sequential unipolar applications using multiple electrode catheter].

The purpose of this study was to examine the effects of radiofrequency energy delivered to the canine endocardium in sequential unipolar applications using multipolar electrode catheter for treatment of ventricular tachycardias. Radiofrequency energy generated by the newly designed device (500 kHz) was delivered to the ventricular myocardium by a quadripolar electrode catheter. The device could indicate output and voltage and could calculate myocardial impedance. In order to determine the power of the ablation in vivo, sequential unipolar application was performed with various output in vitro. A continuous endocardial ablation was achieved with output beyond 15 W and with duration of 5 sec per one pole. According to our measurement, the myocardial impedance in vivo was about three times as large as that in vitro. Therefore, minimal output of 45 W in vivo was applied in the same manner in vitro, which resulted in continuous belt-shaped endocardial ablated lesion. Ventricular stimuli after sequential unipolar applications did not induce ventricular tachycardia in any of the dogs. We conclude that radiofrequency sequential unipolar application using the newly designed device produces a large ablated area and may be suitable for ablation of the foci of ventricular tachycardias.

Animals↗

[An experimental study on the alteration of myocardial tissue by radiofrequency catheter ablation: differences according to the frequency and the device].

To evaluate the alteration of myocardial tissue by radiofrequency (RF) catheter ablation according to differences of the frequency and the device, we applied RF catheter ablation to canine right ventricular myocardium in vitro. The devices delivering RF energy were LL-49(0. 49MHz, fixed voltage mode), RA-50 (13.56MHz, fixed watt mode) and HAT200 (0.52MHz, fixed watt mode with the capability of temperature adjustment). After RF catheter ablation were performed with a unipolar electrode catheter at various output under the same condition of contact, the ablated lesions by each device were compared. Histologically, we recognized coagulation layer with the necrosis of endocardium and the dissociation of myocardium in each experiment. The degree and the size of ablation layer was significantly larger in lower frequency delivery (p less than 0.05) and was significantly smaller by using the device with temperature adjustment as compared with the others (p less than 0.05). It was suggested that the alteration of myocardial tissue ablated with RF energy differ according to the frequency and the mode of output adjustment of the device.

Animals↗

Disposition and metabolism of indeloxazine hydrochloride, a cerebral activator, in rats.

1. The disposition and metabolism of indeloxazine hydrochloride ((+/-)-2-[(inden-7-yloxy)methyl]morpholine hydrochloride) were studied in male Sprague-Dawley rats. 2. After oral administration of 14C-indeloxazine hydrochloride, the plasma concentration of total radioactivity reached a maximum at 15 min and declined with an apparent half-life of 2.2 h in the first 6 h period and declined more slowly thereafter. Unchanged drug in the plasma represented 13.5%, 5.9% and 0.4% of the total radioactivity at 15 min, 1 h and 6 h respectively after administration and levels decayed with a half-life of 0.9 h. 3. After oral and i.v. administration of the labelled compound, the urinary and faecal excretion of radioactivity in 72 h were 61-65% and 31-36% of the dose, respectively. Biliary excretion in bile duct-cannulated animals amounted to 49% of the dose in 72 h. 4. Seven metabolites have been isolated from the plasma or urine and characterized by i.r., n.m.r. and mass spectrometry. They were derived through dihydrodiol formation in the indene ring, hydroxylation of the indene ring and N-acetylation, oxidation and oxidative degradation of the morpholine ring. Some metabolites were excreted as their glucuronic acid or glucose conjugates. The major metabolite appeared to the trans-indandiol analogue of indeloxazine. 5. Possible metabolic pathways of degradation of the morpholine ring are discussed.

Animals↗

Metabolic fate of [14C]SM-1652, a new antipseudomonal cephalosporin, after parenteral administration to rats.

A study of the metabolic fate of [14C]SM-1652 after intravenous or intramuscular injection into rats showed that: (i) the elimination of the labeled compound from the blood was the same after intravenous and intramuscular injections; (ii) the radiolabeled drug was distributed rapidly and widely after intravenous administration with the highest concentration in the kidney and the lowest in the brain; (iii) placental transmission was slight, as it was passed into the milk, where the concentration was about 14% that of plasma; (iv) 33 and 67% of the administered radioactivity was excreted in urine and feces, respectively; (v) radioactivity in both urine and bile was ascribable to unaltered SM-1652; and (vi) upon repeated intramuscular injections twice daily, levels of labeled SM-1652 in tissue increased gradually, reaching a plateau at the 11th injection.

Animals↗

Cost effectiveness of radiofrequency catheter ablation versus medical treatment for paroxysmal supraventricular tachycardia in Japan.

This study evaluated the cost of performing radiofrequency catheter ablation in Japanese patients with paroxysmal supraventricular tachycardia refractory to antiarrhythmic drug therapy in comparison with the cost of continuing pharmacologic treatment. Twenty patients (mean age 44 +/- 14 years) underwent successful ablation: 15 patients with Wolff-Parkinson-White syndrome and five with atrioventricular nodal reentrant tachycardia. The mean duration of symptoms was 77 +/- 60 months. The patients had been treated with 2.6 +/- 1.7 antiarrhythmic drugs before undergoing ablation. Charges derived from hospital bills were compared with the outpatient charges for the year before ablation. The mean hospital stay for the ablation procedure was 4.3 +/- 0.5 days. The mean total charge for ablation was 982,806 yen +/- 103,195, and 5.7 +/- 0.7 times the outpatient charges in the previous year. The majority of radical cure charges were the costs of the electrode catheters used in the ablation procedure. All patients had a successful outcome and required no additional antiarrhythmic drug therapy. If medical treatment were continued without ablation, the mean total life-expectancy charges were estimated at 7,064,726 yen +/- 3,116,621, 41.0 +/- 19.2 times the outpatient charges. The total life charges of medical treatment were significantly more than the total ablation charges (p < 0.001). This study suggests that radiofrequency catheter ablation is of clinical benefit in treating paroxysmal supraventricular tachycardia, and markedly reduces the cost of definitive therapy. This strategy appears to be more economical than pharmacologic treatment.

Adult↗