Impedance, power, and current in radiofrequency ablation: Insights from technical, ex vivo, and clinical studies.

Background: Radiofrequency (RF) power is routinely considered during RF application. In contrast, impedance has been relatively poorly studied, despite also influencing RF lesion creation. The aim of this study was to examine the influence of electric impedance on RF lesion characteristics and on cl...

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Published in:Journal of Cardiovascular Electrophysiology Vol. 31; no. 11; pp. 2836 - 2846
Main Authors: Bourier, Felix, Ramirez, F. Daniel, Martin, Claire A., Vlachos, Konstantinos, Frontera, Antonio, Takigawa, Masateru, Kitamura, Takeshi, Lam, Anna, Duchateau, Josselin, Pambrun, Thomas, Cheniti, Ghassen, Derval, Nicolas, Denis, Arnaud, Sacher, Frédéric, Hocini, Mélèze, Haissaguerre, Michel, Jais, Pierre
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Nov2020
Online Access:View this record in EBSCOhost
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      dt: Nov2020
      vid: 31
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Impedance, power, and current in radiofrequency ablation: Insights from technical, ex vivo, and clinical studies.
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          Bourier, Felix
          Ramirez, F. Daniel
          Martin, Claire A.
          Vlachos, Konstantinos
          Frontera, Antonio
          Takigawa, Masateru
          Kitamura, Takeshi
          Lam, Anna
          Duchateau, Josselin
          Pambrun, Thomas
          Cheniti, Ghassen
          Derval, Nicolas
          Denis, Arnaud
          Sacher, Frédéric
          Hocini, Mélèze
          Haissaguerre, Michel
          Jais, Pierre
        affil: IHU LIRYC, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac‐Bordeaux, France
      sug:
        subj:
          Radiofrequency Ablation
          Electric Impedance
          Electric Capacitance
          Human
          Catheter Ablation Methods
          Electric Stimulation
          Ablation Techniques
      ab: Background: Radiofrequency (RF) power is routinely considered during RF application. In contrast, impedance has been relatively poorly studied, despite also influencing RF lesion creation. The aim of this study was to examine the influence of electric impedance on RF lesion characteristics and on clinical RF ablation parameters. Methods and Results: In the first part of the study, power and impedance were systematically varied and the resulting current was calculated using custom‐made software. In the second part of the study, ablation lesions (n = 40) were analyzed in a porcine ex vivo model. RF applications were delivered in cardiac muscle preparations with systematically varied values of electric impedance using a contact force ablation catheter. In the third part of the study, n = 3378 clinical RF applications were analyzed, power, impedance, and current data were exported and correlated with clinical patient data. 20 ± 3 W/80 Ω, 30 ± 3 W/120 Ω, 40 ± 3 W/160 Ω, and 50 ± 3 W/200 Ω RF applications resulted in 498 ± 40, 499 ± 26, 500 ± 20, and 500 ± 16 mA RF current, which were not significantly different (p =.32). Ablation lesions were significantly different in depth and diameter when applied with the same power but different impedances (p <.01); lesion sizes decreased when increasing impedance. In clinical data, a large range of delivered current (e.g., 39–40 W: 530–754 mA) was measured, due to variations in impedance. Conclusions: RF lesion creation is determined by current rather than by power. During clinical RF ablation procedures, impedance significantly influences current delivery and varies considerably between patients. Impedance and current are clinically relevant parameters that should be considered during RF ablation.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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