Development of an ovine model of pediatric complete heart block
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Development of an ovine model of pediatric complete heart block. / Sill, Bjoern; Roy, Nathalie; Hammer, Peter E; Triedman, John K; Sigg, Daniel C; Kelly, Mark F; Nedder, Arthur; Dunning, Patricia S; Cowan, Douglas B.
In: J SURG RES, Vol. 166, No. 2, 04.2011, p. 103-108.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Development of an ovine model of pediatric complete heart block
AU - Sill, Bjoern
AU - Roy, Nathalie
AU - Hammer, Peter E
AU - Triedman, John K
AU - Sigg, Daniel C
AU - Kelly, Mark F
AU - Nedder, Arthur
AU - Dunning, Patricia S
AU - Cowan, Douglas B
N1 - Copyright © 2011 Elsevier Inc. All rights reserved.
PY - 2011/4
Y1 - 2011/4
N2 - BACKGROUND: Complete heart block is a significant clinical problem that can limit the quality of life in affected children. To understand the pathophysiology of this condition and provide for development of novel therapies, we sought to establish a large animal model of permanent, pacemaker-dependent atrioventricular block (AVB) that mimics the size and growth characteristics of pediatric patients.MATERIALS AND METHODS: We utilized nine immature lambs weighing 10.5 ± 1.4 kg. After implantation of dual-chamber pacemaker devices with fixed leads, AVB was produced by interrupting His-bundle conduction using radio-frequency ablation at the base of the non-coronary cusp of the aortic valve. Ablations (30 to 60 s in duration) were performed under fluoroscopic guidance with electrophysiological monitoring. Interrogation of pacemakers and electrocardiography (ECG) determined the persistence of heart block. Ovine hearts were also examined immunohistochemically for localization of conduction tissue.RESULTS: AVB was produced in eight animals using an atypical approach from the left side of the heart. One animal died due to ventricular fibrillation during ablation proximal to the tricuspid annulus and one lamb was sacrificed postoperatively due to stroke. Four sheep were kept for long-term follow-up (109.8 ± 32.9 d) and required continuous ventricular pacing attributable to lasting AVB, despite significant increases in body weight and size.CONCLUSIONS: We have created a large animal model of pediatric complete heart block that is stable and technically practicable. We anticipate that this lamb model will allow for advancement of cell-based and other innovative treatments to repair complete heart block in children.
AB - BACKGROUND: Complete heart block is a significant clinical problem that can limit the quality of life in affected children. To understand the pathophysiology of this condition and provide for development of novel therapies, we sought to establish a large animal model of permanent, pacemaker-dependent atrioventricular block (AVB) that mimics the size and growth characteristics of pediatric patients.MATERIALS AND METHODS: We utilized nine immature lambs weighing 10.5 ± 1.4 kg. After implantation of dual-chamber pacemaker devices with fixed leads, AVB was produced by interrupting His-bundle conduction using radio-frequency ablation at the base of the non-coronary cusp of the aortic valve. Ablations (30 to 60 s in duration) were performed under fluoroscopic guidance with electrophysiological monitoring. Interrogation of pacemakers and electrocardiography (ECG) determined the persistence of heart block. Ovine hearts were also examined immunohistochemically for localization of conduction tissue.RESULTS: AVB was produced in eight animals using an atypical approach from the left side of the heart. One animal died due to ventricular fibrillation during ablation proximal to the tricuspid annulus and one lamb was sacrificed postoperatively due to stroke. Four sheep were kept for long-term follow-up (109.8 ± 32.9 d) and required continuous ventricular pacing attributable to lasting AVB, despite significant increases in body weight and size.CONCLUSIONS: We have created a large animal model of pediatric complete heart block that is stable and technically practicable. We anticipate that this lamb model will allow for advancement of cell-based and other innovative treatments to repair complete heart block in children.
KW - Animals
KW - Aortic Valve
KW - Atrioventricular Node/pathology
KW - Body Size
KW - Bundle of His/pathology
KW - Catheter Ablation
KW - Disease Models, Animal
KW - Electrocardiography
KW - Female
KW - Heart Block/pathology
KW - Pacemaker, Artificial
KW - Pediatrics
KW - Prosthesis Implantation/methods
KW - Sheep
U2 - 10.1016/j.jss.2010.11.878
DO - 10.1016/j.jss.2010.11.878
M3 - SCORING: Journal article
C2 - 21227467
VL - 166
SP - 103
EP - 108
JO - J SURG RES
JF - J SURG RES
SN - 0022-4804
IS - 2
ER -