Intracoronary Arterial Occlusion: A Novel Technique Potentially Useful for Ablation of Cardiac Arrhythmias

Abstract

To develop a new technique for ablating arrhythmias by interruptingcoronary perfusion of the myocardium, we studied six mongrel dogs, weighing20–35 kg. Under angiographic guidance a microcatheter (1.0 mmdiameter) was introduced into a branch of the left anterior descending orposterior descending coronary artery. A detachable platinum coil (0.0254 cmdiameter, 3 cm length) soldered onto a stainless-steel delivery wire(Guglielmi) was inserted through the microcatheter and advanced to occludethe arterial branch. A 0.5-mA electric current applied to the proximal endof the delivery wire resulted in intravascular thrombosis due to attractionof the negatively charged blood cells, platelets, and fibrinogen to thepositively charged platinum coil. In approximately 4.5 minutes, as thethrombus was formed, electric current dissolved the soldering and detachedthe platinum coil from the delivery wire. Electrocardiograms showed focalST-T changes but no ventricular tachyarrhythmias. Pathologic studiesrevealed thrombosis around the platinum coil and well-demarcated focalischemia/infarction that was correlated with elevation of cardiac enzymes.We conclude that intracoronary arterial embolization and electrothrombosisusing an electrolytic platinum coil can be selectively performed in a verysmall coronary arterial branch, resulting in a limited area of myocardialdamage. This technique is potentially useful for ablating arrhythmias andmay be safer and more controllable than intracoronary alcohol infusion..