Contrasting effects of convective flow on catheter ablation lesion size: cryo versus radiofrequency energy.

BACKGROUND: Cryoablation has now become an alternative to treat many cardiac arrhythmias, and may be the treatment of choice in some patient populations. We compared the effects of convective flow on large-tip cryo and radiofrequency (RF) lesions dimensions. METHODS: Cryoablation and RF ablation wer...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 31; no. 3; pp. 300 - 308
Autores principales: Pilcher TA, Saul JP, Hlavacek AM, Haemmerich D
Formato: research Journal Article
Publicado: Wiley-Blackwell Mar2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2008
      vid: 31
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/j.1540-8159.2008.00989.x
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        atl: Contrasting effects of convective flow on catheter ablation lesion size: cryo versus radiofrequency energy.
      aug:
        au:
          Pilcher TA
          Saul JP
          Hlavacek AM
          Haemmerich D
        affil: Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
      sug:
        subj:
          Catheter Ablation Methods
          Cryosurgery Methods
          Heart Physiology
          Myocardium Pathology
          Animals
          Swine
          Animal Studies
      ab: BACKGROUND: Cryoablation has now become an alternative to treat many cardiac arrhythmias, and may be the treatment of choice in some patient populations. We compared the effects of convective flow on large-tip cryo and radiofrequency (RF) lesions dimensions. METHODS: Cryoablation and RF ablation were performed on porcine heart sections in a saline bath with varying directed flow rates. Cryoablation was performed for 4 minutes on 50 tissue pieces with tip temperature controlled at -80 degrees C. RF ablation was performed on 50 tissue pieces for 60 seconds at 60 degrees C tip temperature. The pieces were placed in culture media for 24 hours, and then sectioned, stained, and measured. RESULTS: Cryoablation and RF lesion sizes varied significantly with flow such that higher flow rates produced smaller cryoablation lesions and larger RF lesions (mean cryoablation volumes: 854 +/- 402, 808 +/- 217, 781 +/- 217, 359 +/- 114, and 292 +/- 117 mm(3), and mean RF volumes: 211 +/- 35, 304 +/- 79, 439 +/- 125, 525 +/- 187, and 597 +/- 126 mm(3) for 0, 1, 2, 3, and 5 L/min flow rates, respectively, P < 0.0005). Trabeculated pieces had larger cryoablation lesions and smaller RF lesions than nontrabeculated ones at higher flow rate (P < 0.005). Cryoablation lesion volume increased as the time to reach -80 degrees C decreased (r(2)= 0.72). CONCLUSION: In contrast to RF ablation, cryoablation lesion size is smaller at high flow rates, and larger at low flow rates due to the warming effects of local convective flow. The effects of high flow are reduced in areas of trabeculation, and the time to reach -80 degrees C predicts cryoablation lesion size.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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