Novel energy modalities for catheter ablation of cardiac arrhythmias PDF
Preview Novel energy modalities for catheter ablation of cardiac arrhythmias
Novel energy modalities for catheter ablation of cardiac arrhythmias Pitfalls and possibilities of potent power sources Colofon Copyright © 2014 Kars Neven No part of this thesis may be reproduced, stored or transmitted, in any form or by any means, without the prior permission of the author. The copyright of the articles that have been accepted for publication, or that have been published, has been transferred to the respective journals. Cover: Shutterstock, Inc. images 94085389 and 139672438 Layout and printed by: Gildeprint, Enschede, The Netherlands ISBN-13: 978-94-6108-699-0 Novel energy modalities for catheter ablation of cardiac arrhythmias Pitfalls and possibilities of potent power sources Nieuwe energievormen voor catheterablatie van hartritmestoornissen Valkuilen en mogelijkheden van krachtige energiebronnen (met een samenvatting in het Nederlands) Neue Energieformen zur Katheterablation von Herzrhythmusstörungen Pitfalls und Möglichkeiten hochpotenter Energiequellen (mit einer Zusammenfassung in deutscher Sprache) Proefschrift ter verkrijging van de graad van doctor aan de Universiteit Utrecht op gezag van de rector magnificus, prof.dr. G.J. van der Zwaan, ingevolge het besluit van het college voor promoties in het openbaar te verdedigen op dinsdag 24 juni 2014 des middags te 4.15 uur door Kars Gaspard Edmond Joseph Neven geboren op 26 mei 1975 te Maastricht Promotor: Prof.dr. P.A.F.M. Doevendans Co-promotor: Dr. F.H.M. Wittkampf Publication of this thesis is financially supported by St. Jude Medical Nederland B.V. “If a man will begin with certainties, he shall end in doubts; but if he will be content to begin with doubts, he shall end in certainties.” Francis Bacon, 1561-1626 dankzij mijn ouders voor Lenny en Frédérique Table of contents 1. General introduction and outline of this thesis 9 High-intensity focused ultrasound 2. Long-term clinical outcome following pulmonary vein isolation with 35 high-intensity focused ultrasound balloon catheters in patients with paroxysmal atrial fibrillation 3. Fatal end of a safety algorithm for pulmonary vein isolation with use of 49 high-intensity focused ultrasound 4. Balloon catheter position and its implications for esophageal temperature 67 during pulmonary vein isolation utilizing high-intensity focused ultrasound 5. Two-year clinical follow-up after pulmonary vein isolation using high-intensity 85 focused ultrasound and an esophageal temperature guided safety algorithm 6. Epicardial ablation: prevention of phrenic nerve damage by pericardial 103 injection of saline and the use of a steerable sheath Irreversible electroporation 7. Myocardial lesion depth with circular electroporation ablation 115 8. Pulmonary vein stenosis after catheter ablation: electroporation versus 131 radiofrequency 9. Low vulnerability of the right phrenic nerve for electroporation ablation 147 10. Safety and feasibility of closed chest epicardial catheter ablation using 161 electroporation 11. Myocardial lesion size after epicardial electroporation catheter ablation 179 following subxiphoid puncture 12. Epicardial linear electroporation ablation and lesion size 195 13. General discussion 211 14. Samenvatting 229 15. Zusammenfassung 235 16. List of publications 241 17. Curriculum vitae 249 18. Acknowledgements 253 Chapter 1 General introduction and outline of this thesis R1 R2 R3 R4 R5 R6 R7 R8 R9 R10 R11 R12 R13 R14 R15 R16 R17 R18 R19 R20 R21 R22 R23 R24 R25 R26 R27 R28 R29 R30 R31 R32 R33 R34 R35 R36 R37 R38 R39 10 | Chapter 1
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