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PubMed1988

Thermal responses to 5.6-GHz radiofrequency radiation in anesthetized rats: effect of chlorpromazine.

Anesthetized rats were exposed to 5.6-GHz continuous wave radiofrequency radiation at an average power density of 60 mW/cm2 (average specific absorption rate 12 W/kg). Exposure was performed to raise colonic temperature from 38.5 to 39.5 degrees C. Following acute administration of chlorpromazine, body temperature exhibited a faster return to baseline temperature when exposure was discontinued. When exposure was initiated at 38.5 degrees C and continued until lethal temperatures resulted, chlorpromazine-treated animals exhibited significantly shorter survival times than saline-treated animals. Thus, although chlorpromazine enhanced thermo-regulatory efficiency at colonic temperatures below 39.5 degrees C, the drug caused increased susceptibility to terminal radiofrequency radiation exposure. The present results, when compared to previous studies of irradiation at 2.8 GHz, indicate that the effects of chlorpromazine on thermal responses to RFR during intermittent and terminal exposure are similar at both 2.8 and 5.6 GHz.

Animals↗
PubMed2006

Development of fast-scanning laser probe system based on knife-edge method for diagnosis of RF surface acoustic wave devices.

This paper describes the development of a high-speed laser probe system for surface acoustic wave (SAW) devices. A fast scanning rate of 2.5 kS/s is realized by continuous stage translation and successive acquisition of the detector output by a high-speed data-logger. Trigger pulses are generated from the output of a high-precision linear-scale installed in the translation stage and fed to the data-logger for the synchronization with the stage movement. The phase-sensitive, knife-edge method is used for the optical detection. This makes the system very unsusceptible to low-frequency mechanical vibration caused by the fast stage translation. The system is applied for the characterization of spurious resonance modes in SAW devices. In conjunction with skillful use of image processing in wavenumber domain, it is shown how the present system is effective in the diagnosis and development of SAW devices.

Electromagnetic Phenomena↗
PubMed1992

Characteristics of local electrogram predicting successful transcatheter radiofrequency ablation of left-sided accessory pathways.

OBJECTIVES: The purpose of this study was to analyze and compare the local electrograms recorded at successful and unsuccessful sites of ablation to identify the criteria that may predict successful sites and minimize unnecessary radiofrequency delivery. BACKGROUND: Transcatheter ablation of accessory pathways using radiofrequency energy requires extremely precise localization of an accessory pathway. METHODS: Local electrograms from 50 consecutive patients with left-sided accessory pathways who underwent transcatheter radiofrequency ablation were analyzed. During catheter ablation, localization of accessory pathways was performed in 39 pathways during pre-excited sinus rhythm and in 14 pathways during orthodromic tachycardia. A total of 429 local electrograms at target sites obtained before delivery of radiofrequency current was analyzed. A prospective study was performed in another 20 patients using the criteria derived from the retrospective study. RESULTS: Accessory pathway conduction block was achieved in 36 (92%) of 39 pathways in which mapping was performed during pre-excited sinus rhythm and in 9 (64%) of 14 pathways in which mapping was performed during orthodromic tachycardia (p less than 0.05). When mapping was performed during pre-excited sinus rhythm, a combination of four variables (that is, an accessory pathway potential, stability of local electrograms, atrial activation greater than 1 mV and ventricular activation preceding the onset of the delta wave) showed a 62% probability of success. In contrast, excluding these variables resulted in a 95% probability of failure (noneffective or transiently effective). The prospective study shows that the use of these criteria can significantly reduce the number of current applications. When mapping was performed during orthodromic tachycardia, recording the earliest atrial activation was the most powerful predictor of success. A stable local electrogram with a small notch on the ventricular potential, presumed to be an accessory pathway potential, may add predictive value. CONCLUSIONS: Transcatheter radiofrequency ablation is highly effective in the treatment of patients with left-sided accessory pathways. Specific characteristics of local electrograms can be important predictors of success or failure. Mapping during pre-excited rhythm renders ablation more effective than does mapping during orthodromic tachycardia.

Adolescent↗
PubMed1992

Recurrence of conduction in accessory atrioventricular connections after initially successful radiofrequency catheter ablation.

The purpose of this study was to characterize the incidence and clinical features of accessory pathway recurrence after initially successful radiofrequency catheter ablation and to identify variables correlated with recurrence. Radiofrequency ablation was performed with a 7F deflectable tip catheter with a large (4 mm in length) distal electrode. Left-sided accessory pathways were approached through the left ventricle and right-sided pathways by way of the right atrium. Patients were included in the study if 1) they had an initially successful procedure, defined as the absence of accessory pathway conduction immediately after ablation, and 2) had undergone a 3-month follow-up electrophysiologic test or had documented recurrence of accessory pathway conduction. Accessory pathway conduction recurred after initially successful ablation in 16 (12%) of 130 patients. Almost half (7 of 16) of these recurrences were in the 1st 12 h after ablation, and the last occurred after 106 days. Return of delta waves on the electrocardiogram (ECG) or spontaneous paroxysmal supraventricular tachycardia was the initial indication of recurrence in 15 of the 16 patients. Two patients with manifest accessory pathways exhibited recurrence with exclusively concealed accessory pathway conduction. Accessory pathways ablated from the tricuspid anulus (right free wall or septal accessory pathways) had a much higher recurrence rate (24%) than did those on the mitral anulus (6%). Fourteen of 15 patients have had successful repeat accessory pathway ablation after the initial recurrence. After a mean follow-up period of 4 +/- 3 months, there have been no repeat recurrences of any of these accessory pathways. It is concluded that accessory pathway recurrence is infrequent after successful radiofrequency catheter ablation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Human auditory system response to pulsed radiofrequency energy in RF coils for magnetic resonance at 2.4 to 170 MHz.

The threshold conditions for an auditory perception of pulsed radiofrequency (RF) energy absorption in the human head have been studied on six volunteers with RF coils for magnetic resonance (MR) imaging. For homogeneous RF exposure with MR head coils in the 2.4- to 170-MHz range and pulse widths 3 microseconds less than or equal to Tp less than 100 microseconds, the auditory thresholds were observed at 16 +/- 4 mJ pulse energy. Localized RF exposure with optimized surface coils positioned flush with the ear lowers the auditory threshold to only 3 +/- 0.6 mJ. The hearing threshold of RF pulses with Tp greater than 200 microseconds occurs at more or less constant peak power levels of typically 150 +/- 50 W for head coils and as low as 20 W for surface coils. The results from this study confirm theoretical predictions from a thermoelastic expansion model and compare well with reported thresholds from near field antenna measurements at 425 to 3000 MHz. Details of the threshold dependence on RF pulse length reveal primary sites of RF to acoustic energy conversion at the mastoid and temporal bone region and the outer layer of the brain from where thermoelastically generated pressure transients excite audible pressure waves at the resonance modes of the skull around 1.7 kHz and of the brain around 11 kHz. If not masked by usually dominating noise from switched gradients, the conditions for hearing RF pulses, as applied to head coils in MR studies with flip angle alpha at main field B0, is given by Tp/ms less than or equal to 0.4 (alpha/pi)B0/[T]. At peak power levels up to 15 kW presently available in clinical MR systems, there is no evidence known for detrimental health effects arising from the RF auditory phenomenon which is a secondary cause associated with primary RF to thermal energy conversion in body tissues. To avoid the RF-evoked sound pressure levels in the head rising above the discomfort threshold at 110 dB SPL, an upper limit of 30 kW applied peak pulse power is suggested for head coils and 6 kW for surface coils.

Auditory Perception↗
PubMed2003

Detection of electron paramagnetic resonance absorption using frequency modulation.

A frequency modulation (FM) method was developed to measure electron paramagnetic resonance (EPR) absorption. The first-derivative spectrum of 1,1-diphenyl-2-picrylhydrazyl (DPPH) powder was measured with this FM method. Frequency modulation of up to 1.6 MHz (peak-to-peak) was achieved at a microwave carrier frequency of 1.1 GHz. This corresponds to a magnetic field modulation of 57microT (peak-to-peak) at 40.3 mT. By using a tunable microwave resonator and automatic control systems, we achieved a practical continuous-wave (CW) EPR spectrometer that incorporates the FM method. In the present experiments, the EPR signal intensity was proportional to the magnitude of frequency modulation. The background signal at the modulation frequency (1 kHz) for EPR detection was also proportional to the magnitude of frequency modulation. An automatic matching control (AMC) system reduced the amplitude of noise in microwave detection and improved the baseline stability. Distortion of the spectral lineshape was seen when the spectrometer settings were not appropriate, e.g., with a lack of the open-loop gain in automatic tuning control (ATC). FM is an alternative to field modulation when the side-effect of field modulation is detrimental for EPR detection. The present spectroscopic technique based on the FM scheme is useful for measuring the first derivative with respect to the microwave frequency in investigations of electron-spin-related phenomena.

Biphenyl Compounds↗
PubMed1980

Induction of calcium-ion efflux from brain tissue by radiofrequency radiation: effect of sample number and modulation frequency on the power-density window.

Changes have been found in calcium-ion binding to brain tissue exposed in vitro to a specific power density (0.83 mW/cm2) of 147-MHz radiation, amplitude modulated by a 16-Hz sine wave. This report replicates and extends this previous work. To define more precisely the range of effective power densities, two different numbers of samples were treated in a Crawford cell. In one series, four brain tissues were exposed at a time; in the other series, four brain tissues plus six dummy loads were exposed together. While the four-sample configuration produced a narrow power-density window, the ten pseudosample configuration resulted in a broader power-density window. The reason for the sample-number dependence is unresolved, but may be due to interactions between samples and field distortions caused by the close spacing. The ten pseudosample configuration was used to test for the presence and rage of a power-density window at a sinusoidal modulation frequency of 9 Hz. The response curve at 9 Hz was essentially identical to the results for 16-Hz sinewave modulation.

Animals↗
PubMed1990

Thermal and physiologic responses to 1200-MHz radiofrequency radiation: differences between exposure in E and H orientation.

Ketamine-anesthetized Sprague-Dawley rats were exposed to far-field 1200-MHz continuous wave radiofrequency radiation in both E and H orientations (long axis of animal parallel to electric or magnetic field, respectively). Power densities were used that resulted in equivalent whole-body specific absorption rates of approximately 8 W/kg in both orientations (20 mW/cm2 for E and 45 mW/cm2 for H). Exposure was conducted to repeatedly increase colonic temperature from 38.5 to 39.5 degrees C in both orientations in the same animal. Irradiation in E orientation resulted in greater colonic, tympanic, left subcutaneous (side toward antenna), and tail heating. The results indicated a more uniform distribution of heat than that which occurred in previous experiments of 2450-MHz irradiation in E and H orientation. A lack of significant differences in blood pressure and heart rate responses between exposures in the two orientations in this study suggest that greater peripheral heating, as was seen in the earlier study of 2450 MHz, is necessary for these differences to occur.

Animals↗
PubMed1987

Effects of radiofrequency radiation and simultaneous exposure with mitomycin C on the frequency of sister chromatid exchanges in Chinese hamster ovary cells.

Chinese hamster ovary (CHO) cells were exposed for 2 hr with and without mitomycin C (MMC) (1 X 10(-8)M) to pulsed wave radiofrequency radiation (RFR) at 2450 MHz. The repetition rate of 25,000 pulses per sec (pps), pulse width of 10 microseconds, and exposure geometry used, resulted in a specific absorption rate (SAR) of 33.8 W/kg. The following exposure regimens were used: a 37 degrees C water bath control; a water bath temperature control (TC) in which the continuously monitored medium temperature closely followed the temperature rise in the RFR-exposed flasks; and the RFR-exposed cells in a water bath set at 37 degrees C prior to exposure. RFR exposure resulted in a maximum cell culture medium temperature of 39.2 degrees C. In the absence of MMC, there was no significant increase in sister chromatid exchange (SCE) in the RFR-exposed or TC groups over that of the 37 degrees C control. When a simultaneous treatment of RFR and MMC occurred there was no statistical difference in SCE frequency from that caused by chemical treatment alone.

Animals↗
PubMed2001

Effect of exposure to 900 MHz radiofrequency radiation on intrachromosomal recombination in pKZ1 mice.

Radiofrequency (RF) radiation emitted from mobile phones is not considered to be directly genotoxic, but it may have downstream effects on cellular DNA. We studied the effect of 4 W/kg pulsed 900 MHz RF radiation on somatic intrachromosomal recombination in the spleen in the pKZ1 recombination mutagenesis model. Somatic intrachromosomal recombination inversion events were detected in spleen tissue of pKZ1 mice by histochemical staining for E. coli beta-galactosidase protein in cells in which the lacZ transgene has undergone an inversion event. pKZ1 mice were exposed daily for 30 min to plane-wave fields of 900 MHz with a pulse repetition frequency of 217 Hz and a pulse width of 0.6 ms for 1, 5 or 25 days. Three days after the last exposure, spleen sections were screened for DNA inversion events. There was no significant difference between the control and treated groups in the 1- and 5-day exposure groups, but there was a significant reduction in inversions below the spontaneous frequency in the 25-day exposure group. This observation suggests that exposure to RF radiation can lead to a perturbation in recombination frequency which may have implications for recombination repair of DNA. The biological significance of a reduction below the spontaneous frequency is not known. The number of mice in each treatment group in this study was small (n = 10 or n = 20). Therefore, repetition of this study with a larger number of animals is required to confirm these observations.

Animals↗
PubMed1992

Analysis of local electrogram characteristics correlated with successful radiofrequency catheter ablation of accessory atrioventricular pathways.

UNLABELLED: Due to the limited myocardial lesions produced by radiofrequency current, the ablation of accessory pathways (AP) requires precise localization of such connections. The purpose of this study was to ascertain which characteristic(s) of the local bipolar electrogram, recorded from the ablation and adjacent electrode immediately prior to the application of radiofrequency current, correlated with precision in localization adequate to permit AP ablation. Signal analysis was performed for 326 sets of electrograms preceding the attempted ablation of 107 APs in 100 consecutive patients. For 80 antegrade APs, the following variables were evaluated: (1) the presence or absence of an AP potential; (2) the local atrial-AP interval; (3) the local atrioventricular (AV) interval; and (4) the relationship between the onset of local ventricular depolarization and onset of delta wave of the surface electrocardiogram. For the 27 concealed APs, the following characteristics were evaluated: (1) the presence or absence of an AP potential; and (2) the local VA interval during reciprocating tachycardia or ventricular pacing. RESULTS: Antegrade APs: By statistical analysis, the best correlate of successful ablation of an antegrade AP was a local AV interval less than or equal to 40 msec (positive predictive value = 94%; 95% confidence intervals [CI] = 81%-100%). Local AV intervals less than or equal to 50 msec preceded 88% of successful AP ablations, compared to only 8% of failed radiofrequency current applications. The positive predictive value of the other variables were: presence of an AP potential: 35% (95% CI = 27%-40%); local atrial-AP intervals less than or equal to 40 msec: 54% (95% CI = 43%-66%); and local ventricular depolarization preceding onset of the delta wave 43% (95% CI = 34%-52%). For concealed APs, the positive predictive value of a VA interval less than 60 msec was 71% (95% CI = 48%-88%); the positive predictive value for the presence of an AP potential was 58% (95% CI = 32%-81%). CONCLUSIONS: No single electrogram characteristic had a positive predictive value and a sensitivity greater than 90% for AP localization adequate for radiofrequency current ablation. For antegrade APs, the best correlate of adequate localization was a local AV interval less than or equal to 40 msec; as a corollary, radiofrequency current applications at sites where the local AV was greater than 60 msec, were unlikely to be effective. Objective criteria for the localization of concealed APs were less certain. Electrogram analysis, as a guide to AP localization and ablation, requires careful analysis of multiple variables, with analysis of the local AV interval a salient objective factor.

Adult↗
PubMed1991

Single-catheter approach to radiofrequency current ablation of left-sided accessory pathways in patients with Wolff-Parkinson-White syndrome.

BACKGROUND: Catheter ablation with the use of radiofrequency current has been introduced as a therapeutic option for patients with tachyarrhythmias mediated by an accessory atrioventricular pathway. The technique conventionally implies the introduction of several catheters into the heart for assessment of electrophysiological parameters as well as for localization of the accessory pathway and may last for several hours. METHODS AND RESULTS: Thirty-four patients with Wolff-Parkinson-White syndrome and a delta wave pattern indicative of an overt (i.e., capable of consistent antegrade conduction) left-sided free-wall accessory pathway underwent attempts at radiofrequency current ablation of the pathway with the use of just one catheter. No patient had a previous electrophysiological study. The catheter was introduced into the left ventricle close to the mitral annulus and was used for pathway localization as well as for ablation. The approach was completely successful in 30 patients (88%). In the remaining four patients, ablation of the pathway was achieved by using the multiple-catheter approach. Overall procedure duration was 2.0 +/- 1.1 hours; radiation exposure time was 22.8 +/- 20.4 minutes (median, 17.3 minutes). There were no acute complications. CONCLUSIONS: The single-catheter approach to radiofrequency current ablation of overt left-sided free-wall accessory pathways is feasible, safe, and effective in the majority of patients. The approach requires considerable investigator experience but significantly reduces procedure duration and radiation exposure time.

Adolescent↗
PubMed1990

Influence of radiofrequency radiation on chromosome aberrations in CHO cells and its interaction with DNA-damaging agents.

A limited number of contradictory reports have appeared in the literature about the ability of radiofrequency (rf) radiation to induce chromosome aberrations in different biological systems. The technical documentation associated with such reports is often absent or deficient. In addition, no information is available as to whether any additional genotoxic hazard would result from a simultaneous exposure of mammalian cells to rf radiation and a chemical which (by itself) induces chromosome aberrations. In the work described, we have therefore tested two hypotheses. The first is that rf radiation by itself, at power densities and exposure conditions which are higher than is consistent with accepted safety guidelines, can induce chromosome aberrations in mammalian cells. The second is that, during a simultaneous exposure to a chemical known to be genotoxic, rf radiation can affect molecules, biochemical processes, or cellular organelles, and thus result in an increase or decrease in chromosome aberrations. Mitomycin C (MMC) and Adriamycin (ADR) were selected because they act by different mechanisms, and because they might put normal cells at risk during combined-modality rf radiation (hyperthermia)-chemotherapy treatment of cancer. The studies were performed with suitable 37 degrees C and equivalent convection heating-temperature controls in a manner designed to discriminate between any thermal and possible nonthermal action. Radiofrequency exposures were conducted for 2 h under conditions resulting in measurable heating (a maximum increase of 3.2 degrees C), with pulsed-wave rf radiation at a frequency of 2450 MHz and an average net forward power of 600 W, resulting in an SAR of 33.8 W/kg. Treatments with MMC or ADR were for a total of 2.5 h and encompassed the 2-h rf radiation exposure period. The CHO cells from each of the conditions were subsequently analyzed for chromosome aberrations. In cells exposed to rf radiation alone, and where a maximum temperature of approximately 40 degrees C was achieved in the tissue culture medium, no alteration in the frequency from 37 degrees C control levels was observed. Relative to the chemical treatment with MMC alone at 37 degrees C, for two different concentrations, no alteration was observed in the extent of chromosome aberrations induced by either simultaneous rf radiation exposure or convection heating to equivalent temperatures. At the ADR concentration that was used, most of the indices of chromosome aberrations which were scored indicated a similar result.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed2000

On the conversion of triple- to single-quantum coherences in MQMAS NMR.

A systematic experimental and numerical evaluation of several basic approaches to multiple-quantum magic angle spinning (MQMAS) NMR is presented for spin-32 nuclei. The approaches use identical MQ excitation, via a single RF pulse of high power, and three types of methods for conversion to observable coherence: (a) nutation by strong continuous wave pulse; (b) rotation-induced adiabatic coherence transfer (RIACT), and (c) fast amplitude modulation (FAM-1). The optimization strategies and maximum achievable MQMAS efficiencies of (87)Rb in RbNO(3) and LiRbSO(4) are investigated using several coherence transfer schemes under a wide range of experimental parameters. These parameters include the strength of the RF magnetic field nu(RF), the sample rotation speed nu(R), the length of the conversion period, and the modulation frequency in FAM-1. The data provide new insights into the spin dynamics involved in these techniques and the experimental guidelines for achieving the best sensitivity. The RF requirements for maximum efficiency of conversion depend on the method to be used. In general, FAM-1 performs better than the nutation and RIACT methods in terms of efficiency and off-resonance behavior, especially when nu(RF) is small compared to the quadrupole frequency nu(Q). The experiments performed using nutation, RIACT, and FAM-1 methods yield similar resolution in the isotropic dimension, regardless of nu(RF).

Magnetic Resonance Spectroscopy↗
PubMedDate not supplied

Newly developed transurethral radiofrequency thermotherapy device for benign prostatic hyperplasia: a pilot study in canine prostate.

The safety and efficacy of transurethral microwave thermo-therapy (TUMT) for the treatment of symptomatic benign prostatic hyperplasia (BPH) have been demonstrated in the urological literature. Since a radiofrequency electromagnetic wave has deeper and more even transmission of heat to tissues than a microwave, we have developed a new prototype device for transurethral thermotherapy using a radiofrequency electromagnetic wave. The device consists of a microcomputer-controlled heat generator operating at 8 Mhz, a temperature monitoring system, a urethral cooling system and a urethral applicator and a rectal thermosensor probe. A balloon electrode encased in a specialized Foley catheter is connected parallel to twin plate electrodes on both sides of the pelvic region. An 8-MHz electromagnetic wave is directed to the prostate by means of capacitive coupling. The water coolant continuously perfused through the catheter allows high temperatures within the prostate while preserving the urethral mucosa. Heating experiment using agar phantom showed the hot spots to be distributed at 0.5-3 cm from the catheter surface. Heating experiment using canine prostates demonstrated that an intraprostatic temperature of > 48 degrees C could be achieved while the urethral and rectal temperatures had not exceeded 36 and 40 degrees C respectively. Histological examination immediately after the experiment showed the urethral mucosa to be preserved while coagulation necrosis of the periurethral prostate accompanied with congestion and hemorrhage of small blood vessels were observed at 5-8 mm from the urethra. The bladder and the rectum showed no gross alterations. Histopathological examination 10 days after the experiment revealed the intact urethral mucosa and mild mononuclear infiltration around the destroyed periurethral glands.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Erythrocyte hemolysis by radiofrequency fields.

A field-strength-dependent hemolytic effect of continuous-wave radiofrequency (RF) exposure in vitro has been demonstrated. Erythrocytes in whole heparinized rabbit blood were hemolyzed by a 2-h exposure to 50- or 100-MHz RF fields at field strengths of greater than 4 V/cm. An effect of comparable magnitude resulted from exposure to 10-MHz RF at a field strength of 9 V/cm. Sample temperatures were maintained at 22.5 degrees +/- 0.2 degrees C. There was no apparent involvement of heating or temperature gradients, nor were there any RF exposure effects on cellular K+ or Na+ concentration, nor on pH. The mechanism of the hemolytic effect is not known. Since the percentage of lysed erythrocytes was less than 1% and there was an absence of effects on cellular cation concentrations, RF radiation may have irreversibly altered the plasma membrane permeability of a sensitive subpopulation of red cells (possibly aged cells) leading to osmotic lysis. RF radiation at these frequencies appears to affect red cells in a manner that is qualitatively and quantitatively different from microwave radiation.

Animals↗
PubMed1992

Radiofrequency catheter ablation for the treatment of human type 1 atrial flutter. Identification of a critical zone in the reentrant circuit by endocardial mapping techniques.

BACKGROUND: Recent studies of human type 1 atrial flutter demonstrated reentry in the right atrium and an area of slow conduction in the low posteroseptal right atrium. Direct-current catheter ablation of this area has been only moderately successful in preventing recurrence. Therefore, we performed endocardial activation mapping and entrainment pace mapping during atrial flutter to determine the critical site for radiofrequency ablation of this arrhythmia. METHODS AND RESULTS: Twelve consecutive patients (seven men and five women; age, 21-73 years) with type 1 atrial flutter (mean cycle length, 253 +/- 39 msec) underwent right atrial endocardial activation and entrainment pace mapping using standard transvenous catheter techniques to localize the atrial flutter reentrant circuit, the area of slow conduction, and the exit site from the area of slow conduction. Upon identifying appropriate sites, radiofrequency energy (16-29 W) was applied via a 4-mm tipped catheter. Activation mapping of atrial flutter revealed a counterclockwise reentrant wave front originating just inferior or posterior to the coronary sinus ostium, proceeding superiorly in the atrial septum to the right atrial free wall, then inferiorly toward the tricuspid annulus and finally medially between the inferior vena cava and the tricuspid annulus, where low-amplitude fragmented electrical activity was noted. Entrainment pace mapping from this area produced an exact P wave match to atrial flutter on 12-lead ECG with a long (greater than 40 msec) stimulus-to-P interval indicating slow conduction, whereas pacing just inferior or posterior to the coronary sinus ostium produced an exact P wave match with a short stimulus-to-P interval (less than 40 msec), presumably identifying the exit site from the area of slow conduction. Radiofrequency energy (one to 14 applications) was effective in terminating and preventing reinduction of atrial flutter in 10 patients. In two patients, atrial flutter was not terminated during radiofrequency energy application but during subsequent pacing attempts. Sites where ablation was successful, located just inferior or posterior to the coronary sinus ostium, were characterized by discrete electrograms with activation times of -20 to -50 msec before P wave onset and exact entrainment pace maps with a stimulus-to-P interval of 20 to 40 msec, consistent with the exit site from the area of slow conduction. Follow-up (mean, 16 +/- 9 weeks; range, 2-31 weeks) revealed recurrence of the original atrial flutter in two patients, one of whom underwent repeat ablation without further recurrence, self-limited infrequent recurrence of a new atrial flutter or atrial fibrillation in three suppressed by beta-blocker or digoxin, and no recurrence in seven. CONCLUSIONS: 1) Radiofrequency energy applied to a critical area in the atrial flutter reentrant circuit, inferior or posterior to the coronary sinus ostium, will terminate and prevent arrhythmia reinduction. 2) Long-term follow-up in a larger series of patients will be required to confirm efficacy of this technique, although short-term results look promising.

Adult↗
PubMed1994

An evaluation of safe practices to restrict exposure to electric and magnetic fields from therapeutic and surgical diathermy equipment.

Stray electric and magnetic fields have been measured near to therapeutic and surgical diathermy equipment for many different treatments. The highest field strengths are associated with continuous wave (cw) 27 MHz therapeutic diathermy equipment for which fields above national reference levels extend for 1 m from the electrodes and cables. The extent of the fields does not vary substantially with the type of treatment being performed. Recommendations that operators remain 1.0 m from cw therapeutic diathermy equipment, 0.5-0.8 m from pulsed treatments with capacitive electrodes and 0.2 m from pulsed inductive applicators can be applied to restrict exposure for any treatment with each type of unit. In a proposed European Community (EC) directive, action levels similar in magnitude to the reference levels are used to trigger requirements for assessments of hazard, measures to reduce exposure and personnel training. Assessments and appropriate recommendations of measures to reduce exposure can be linked to the type of equipment. Fields associated with electrosurgical units operating at frequencies of 0.3-0.5 MHz only approached reference levels within 20-30 cm of the cables, and because of the relatively short durations of the emissions, precautions were considered unnecessary with the units tested.

Diathermy↗