In vivo biophysical characterization of very high power, short duration, temperature‐controlled lesions.

Introduction: A very high‐power short‐duration (vHPSD) strategy of radiofrequency (RF) ablation aims to minimize conductive heating and increase resistive heating. This study aimed to clarify the contribution of contact force (CF) and temperature and their interrelationship in making an adequate les...

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Published in:Pacing & Clinical Electrophysiology Vol. 44; no. 10; pp. 1717 - 1724
Main Authors: Stabile, Giuseppe, Schillaci, Vincenzo, Strisciuglio, Teresa, Arestia, Alberto, Agresta, Alessia, Shopova, Gergana, De Simone, Antonio, Solimene, Francesco
Format: diagnostic images research tables/charts Journal Article
Published: Wiley-Blackwell Oct2021
Online Access:View this record in EBSCOhost
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      dt: Oct2021
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      pub: Wiley-Blackwell
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        10.1111/pace.14358
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        atl: In vivo biophysical characterization of very high power, short duration, temperature‐controlled lesions.
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          Stabile, Giuseppe
          Schillaci, Vincenzo
          Strisciuglio, Teresa
          Arestia, Alberto
          Agresta, Alessia
          Shopova, Gergana
          De Simone, Antonio
          Solimene, Francesco
        affil: Clinica Montevergine, Mercogliano Avellino,, Italy
      sug:
        subj:
          Atrial Fibrillation Surgery
          Catheter Ablation Methods
          Treatment Duration
          Temperature
          Human
          Descriptive Statistics
          Pulmonary Veins Surgery
          Electric Impedance
          Multivariate Analysis
          ROC Curve
      ab: Introduction: A very high‐power short‐duration (vHPSD) strategy of radiofrequency (RF) ablation aims to minimize conductive heating and increase resistive heating. This study aimed to clarify the contribution of contact force (CF) and temperature and their interrelationship in making an adequate lesion with the vHPSD catheter. Methods: We enrolled 46 consecutive patients undergoing first catheter ablation for atrial fibrillation (AF). The vHPSD ablation was performed applying 90 W, for 4 s, with an irrigation of 8 ml/min. During an application, an impedance drop (ID) ≥10 Ω was regarded as an adequate lesion formation. Results: The mean procedural time was 95 ± 15 min. First‐pass isolation was reached in 89% of patients and at the end of the procedure all pulmonary veins were isolated. No steam pop nor procedural complication occurred. A total of 3829 qualified RF points were analyzed and the median values of ID, CF and maximum temperature were respectively 10.6 (IQR 8.6–13.1) Ohm, 9 (5.8–13.8) g, 46.8 (44.1–49.8) °C. The mean ID significantly increased in parallel with the increasing CF as well as with the increasing maximum temperature. In the multivariable analysis only the CF and the maximum temperature were independent predictors of ID. From receiver operating characteristic curve analysis, a CF of 8 g and a maximum temperature of 47°C are the optimal cutoff discriminatory value for adequate lesion formation. Conclusions: The vHPSD ablation is highly effective and safe. The CF and the maximum temperature are independent predictors of adequate lesion formation assessed by means of ID.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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