A new instrument of suction support adapter system for epicardial radiofrequency ablation Shinichi Kadoya, MD, Go Watanabe, MD, Yoshinao Koshida, MD,

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A new instrument of suction support adapter system for epicardial radiofrequency ablation Shinichi Kadoya, MD, Go Watanabe, MD, Yoshinao Koshida, MD, Makoto Oda, MD, Shojiro Yamaguchi, MD The Journal of Thoracic and Cardiovascular Surgery Volume 139, Issue 6, Pages 1618-1622 (June 2010) DOI: 10.1016/j.jtcvs.2009.10.019 Copyright © 2010 Terms and Conditions

Figure 1 Cobra surgical probe and suction support adapter. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1618-1622DOI: (10.1016/j.jtcvs.2009.10.019) Copyright © 2010 Terms and Conditions

Figure 2 Schema of suction support adapter. With the use of the suction support adapter, the atrial wall folds into an inverted-U shape and is suctioned into the silicone tube. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1618-1622DOI: (10.1016/j.jtcvs.2009.10.019) Copyright © 2010 Terms and Conditions

Figure 3 Schema of the epicardial ablation line (viewed from dorsal side). SVC, Superior vena cava; IVC, inferior vena cava; RA, right atrium; LA, left atrium; PV, pulmonary veins; A1, A2, and S, electrodes. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1618-1622DOI: (10.1016/j.jtcvs.2009.10.019) Copyright © 2010 Terms and Conditions

Figure 4 Electrophysiologic evaluation. In the group in which the suction support adapter was used, electrode A1 inside the isolation area was synchronized with the stimulus electrode (arrows) and electrode A2 and the limb lead outside the isolation area were not synchronized with the stimulus electrode (arrows). This indicates that electrical isolation occurred. The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1618-1622DOI: (10.1016/j.jtcvs.2009.10.019) Copyright © 2010 Terms and Conditions

Figure 5 Normal cardiac muscle was stained red with triphenyltetrazolium chloride, and a distinct border was seen with a region of yellowish coagulation. A, In group C, the area of coagulation was large and transmurality was not seen (arrows). B, In group S, the area of coagulation was narrow and there was transmurality (arrows). In the azan-stained specimens, the area of coagulation was stained blue. C, In group C, the area of coagulation was large and transmurality was not seen (arrows). D, In group S, the area of coagulation was narrow and there was transmurality (arrows). The Journal of Thoracic and Cardiovascular Surgery 2010 139, 1618-1622DOI: (10.1016/j.jtcvs.2009.10.019) Copyright © 2010 Terms and Conditions