Comparative performance of open thorax epicardial linear cryoprobe ablation versus focal tip radiofrequency catheter ablation in ventricular scar
- 1UCLA Cardiac Electrophysiology Division, Ronald Reagan UCLA Medical Center, Los Angeles, CA USA
- 2UCLA Department of Pathology, Ronald Reagan UCLA Medical Center, Los Angeles, CA USA
Abstract
Background: Epicardial cryoablation is increasingly utilized in open surgical procedures for treatment of ventricular arrhythmias in patients with structural heart disease when percutaneous epicardial access cannot be obtained. There are limited data regarding the effects of cryoablation within ventricular scar tissue, particularly in comparison to the performance of radiofrequency (RF) catheter ablation. This study aimed to investigate the comparative performance of ablation delivered epicardially in an open chest animal model with a linear cryoprobe versus a radiofrequency catheter.
Methods: An infarct model was created in five Yorkshire swine using microsphere injection into the left anterior descending artery. After 6–8 weeks, animals underwent median sternotomy with targeted epicardial RF ablation lesions, and linear cryoablation lesions were delivered to myocardial infarct scar regions. Specimens were pressure perfused with 10% formalin, and histological analysis was performed.
Results: Out of 25 epicardial RF lesions, 13 were visible and able to be analyzed. All 15 epicardial cryoablation lesions were visible. All 15 cryoablation lesions had transmural effect within scar where tissue thickness was ≤6 mm, whereas only 62% of evaluable RF lesions were transmural in scar (p = 0.01). Average cryoablation lesion depth was 4.2 ± 1.1 mm in scar and 5.6 ± 1.4 mm in border zone.
Conclusion: Linear epicardial cryoablation is a useful tool in open surgical procedures to treat ventricular arrhythmias in structural heart disease. Cryoablation can achieve transmurality in tissue with ≤ 6 mm thickness with more technically reliable effect compared to catheter RF in the open chest.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10840-026-02412-9.
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BibTeX
@article{hayase2026comparative,
title = {{Comparative performance of open thorax epicardial linear cryoprobe ablation versus focal tip radiofrequency catheter ablation in ventricular scar}},
author = {Justin Hayase and Rami Aladham and Min Zhang and Gregory A. Fishbein and Takanori Sato and Shumpei Mori and Kalyanam Shivkumar and Olujimi A. Ajijola and Jason S. Bradfield},
journal = {Journal of Interventional Cardiac Electrophysiology},
year = {2026},
month = jul,
doi = {10.1007/s10840-026-02412-9},
url = {https://doi.org/10.1007/s10840-026-02412-9},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Comparative performance of open thorax epicardial linear cryoprobe ablation versus focal tip radiofrequency catheter ablation in ventricular scar
AU - Justin Hayase
AU - Rami Aladham
AU - Min Zhang
AU - Gregory A. Fishbein
AU - Takanori Sato
AU - Shumpei Mori
AU - Kalyanam Shivkumar
AU - Olujimi A. Ajijola
AU - Jason S. Bradfield
PY - 2026
DA - 2026/07/24
JO - Journal of Interventional Cardiac Electrophysiology
DO - 10.1007/s10840-026-02412-9
UR - https://doi.org/10.1007/s10840-026-02412-9
AB - Background: Epicardial cryoablation is increasingly utilized in open surgical procedures for treatment of ventricular arrhythmias in patients with structural heart disease when percutaneous epicardial access cannot be obtained. There are limited data regarding the effects of cryoablation within ventricular scar tissue, particularly in comparison to the performance of radiofrequency (RF) catheter ablation. This study aimed to investigate the comparative performance of ablation delivered epicardially in an open chest animal model with a linear cryoprobe versus a radiofrequency catheter. Methods: An infarct model was created in five Yorkshire swine using microsphere injection into the left anterior descending artery. After 6–8 weeks, animals underwent median sternotomy with targeted epicardial RF ablation lesions, and linear cryoablation lesions were delivered to myocardial infarct scar regions. Specimens were pressure perfused with 10% formalin, and histological analysis was performed. Results: Out of 25 epicardial RF lesions, 13 were visible and able to be analyzed. All 15 epicardial cryoablation lesions were visible. All 15 cryoablation lesions had transmural effect within scar where tissue thickness was ≤6 mm, whereas only 62% of evaluable RF lesions were transmural in scar (p = 0.01). Average cryoablation lesion depth was 4.2 ± 1.1 mm in scar and 5.6 ± 1.4 mm in border zone. Conclusion: Linear epicardial cryoablation is a useful tool in open surgical procedures to treat ventricular arrhythmias in structural heart disease. Cryoablation can achieve transmurality in tissue with ≤ 6 mm thickness with more technically reliable effect compared to catheter RF in the open chest. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10840-026-02412-9.
SN - 1383-875X
SN - 1572-8595
ER -