TY - JOUR
T1 - Gastric ablation as a novel technique for modulating electrical conduction in the in vivo stomach
AU - Aghababaie, Zahra
AU - Paskaranandavadivel, Niranchan
AU - Amirapu, Satya
AU - Chan, Chih Hsiang Alexander
AU - Du, Peng
AU - Asirvatham, Samuel J.
AU - Farrugia, Gianrico
AU - Beyder, Arthur
AU - O’Grady, Gregory
AU - Cheng, Leo K.
AU - Angeli-Gordon, Timothy R.
N1 - Funding Information:
This work was supported by the New Zealand Health Research Council, Royal Society Te Apārangi, Auckland Medical Research Foundation, New Zealand Society of Gastroenterology, Medical Technologies Centre of Research Excellence (MedTech CoRE), and the National Institutes of Health DK57061 and DK52766. T. R. Angeli-Gordon is supported by a Rutherford Discovery Fellowship from the Royal Society Te Apārangi and was previously supported by an Edith C. Coan Postdoctoral Research Fellowship from the Auckland Medical Research Foundation.
Publisher Copyright:
0193-1857/21 Copyright © 2021 the American Physiological Society
PY - 2021/4
Y1 - 2021/4
N2 - Gastric motility is coordinated by underlying bioelectrical “slow wave” activity. Slow wave dysrhythmias are associated with motility disorders, including gastroparesis, offering an underexplored potential therapeutic target. Although ablation is widely used to treat cardiac arrhythmias, this approach has not yet been trialed for gastric electrical abnormalities. We hypothesized that ablation can create localized conduction blocks and modulate slow wave activation. Radiofrequency ablation was performed on the porcine serosa in vivo, encompassing a range of parameters (55–85C, adjacent points forming a line, 5–10 s/point). High-resolution electrical mapping (16 16 electrodes; 6 6 cm) was applied to define baseline and acute postablation activation patterns. Tissue damage was evaluated by hematoxylin and eosin and c-Kit stains. Results demonstrated that RF ablation successfully induced complete conduction block and a full thickness lesion in the muscle layer at energy doses of 65–75C for 5–10 s/point. Gastric ablation may hold therapeutic potential for gastric electrical abnormalities in the future. NEW & NOTEWORTHY This study presents gastric ablation as a new method for modulating slow wave activation and propagation in vivo, by creating localized electrical conduction blocks in the stomach, validated by high-resolution electrical mapping and histological tissue analysis. The results define the effective energy dose range for creating conduction blocks, while maintaining the mucosal and submucosal integrity, and demonstrate the electrophysiological effects of ablation. In future, gastric ablation can now be translated toward disrupting dysrhythmic slow wave activation.
AB - Gastric motility is coordinated by underlying bioelectrical “slow wave” activity. Slow wave dysrhythmias are associated with motility disorders, including gastroparesis, offering an underexplored potential therapeutic target. Although ablation is widely used to treat cardiac arrhythmias, this approach has not yet been trialed for gastric electrical abnormalities. We hypothesized that ablation can create localized conduction blocks and modulate slow wave activation. Radiofrequency ablation was performed on the porcine serosa in vivo, encompassing a range of parameters (55–85C, adjacent points forming a line, 5–10 s/point). High-resolution electrical mapping (16 16 electrodes; 6 6 cm) was applied to define baseline and acute postablation activation patterns. Tissue damage was evaluated by hematoxylin and eosin and c-Kit stains. Results demonstrated that RF ablation successfully induced complete conduction block and a full thickness lesion in the muscle layer at energy doses of 65–75C for 5–10 s/point. Gastric ablation may hold therapeutic potential for gastric electrical abnormalities in the future. NEW & NOTEWORTHY This study presents gastric ablation as a new method for modulating slow wave activation and propagation in vivo, by creating localized electrical conduction blocks in the stomach, validated by high-resolution electrical mapping and histological tissue analysis. The results define the effective energy dose range for creating conduction blocks, while maintaining the mucosal and submucosal integrity, and demonstrate the electrophysiological effects of ablation. In future, gastric ablation can now be translated toward disrupting dysrhythmic slow wave activation.
KW - Conduction block
KW - Dysrhythmia
KW - Electrophysiology
KW - Interstitial cells of Cajal
KW - Slow wave
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U2 - 10.1152/AJPGI.00448.2020
DO - 10.1152/AJPGI.00448.2020
M3 - Article
C2 - 33470186
AN - SCOPUS:85104209877
VL - 320
SP - G573-G585
JO - American Journal of Physiology - Renal Fluid and Electrolyte Physiology
JF - American Journal of Physiology - Renal Fluid and Electrolyte Physiology
SN - 1931-857X
IS - 4
ER -