Comparison of In Vivo Tissue Temperature Profile and Lesion Geometry for Radiofrequency Ablation With High Power-Short Duration and Moderate Power-Moderate Duration: Effects of Thermal Latency and Contact Force on Lesion Formation
Comparison of In Vivo Tissue Temperature Profile and Lesion Geometry for Radiofrequency Ablation With High Power-Short Duration and Moderate Power-Moderate Duration: Effects of Thermal Latency and Contact Force on Lesion Formation
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DOI：
10.1161/circep.121.009899
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发表时间：
2021-07-01
影响因子：
8.4
通讯作者：
Jackman, Warren M.
中科院分区：
文献类型：
--
作者：
Nakagawa, Hiroshi;Ikeda, Atsushi;Jackman, Warren M.
背景：在短时间射频(RF)应用中，射频终止后组织温度持续升高(热潜伏期)，这可能导致射频终止后病变的生长。目的：比较极高功率-极短射频(90W/4 S)、高功率-短射频(50W/10 S)和中功率-中射频(30W/30 S)射频消融犬大腿肌肉和不停跳心脏的体内组织温度分布(热潜伏期)、病变大小、蒸汽爆裂和血栓发生率。方法：在5只犬的股部肌肉准备中，将3.5 mm的消融电极与肌肉垂直或平行放置在10g或30g的接触力下，电极上分别有66个或56个小孔(QDOT-Micro或ThermoCoolSmartTouch-SF)。采用90W/4 S导管、50W/10 S导管和30W/30 S导管(SF导管)分别置入120个RFs。测量电极温度、电极-组织界面温度以及3 mm和7 mm深度的组织温度。结果：在大腿肌肉准备中，90W/4 S、50W/10 S和30W/30 S的RFs的组织温度和病变大小(深度、直径和体积)最低/最小，其次是50W/10 S，30W/30 S最大。30W/30时S(P=50℃，3 mm深度)最小，90W/4 S为88.0±-7.6%，50W/10 S为57.7%/-14.6%，30W/30 S为31.9%/-8.5%(P
Background: With short radiofrequency (RF) applications, tissue temperature continues to rise after RF termination (thermal latency), which may result in lesion growth after RF termination. The purpose was to compare in vivo tissue temperature profile (thermal latency), lesion size, and the incidence of steam pop and thrombus between RF ablation with very high power-very short RF (90 W/4 s), high power-short RF (50 W/10 s), and moderate power-moderate RF (30 W/30 s) in a canine thigh muscle preparation and beating heart. Methods: In the thigh muscle preparation (5 dogs), a 3.5-mm ablation electrode with 66 or 56 small irrigation holes (QDOT-Micro or ThermoCoolSmartTouch-SF, respectively) was held perpendicular or parallel to the muscle at 10g or 30g contact force. Total of 120 RFs were delivered at 90 W/4 s (QDOT catheter), 50 W/10 s, or 30 W/30 s (SF catheter). Electrode temperature, electrode-tissue interface temperature, and tissue temperatures at 3- and 7-mm depths were measured. In 6 closed-chest dogs, total of 72 RFs were delivered in the ventricle at 90 W/4 s, 50 W/10 s, or 30 W/30 s. Results: In the thigh muscle preparation, tissue temperatures and lesion size (depth, diameter, and volume) were the lowest/smallest for RFs at 90 W/4 s, followed by 50 W/10 s, and the greatest for 30 W/30 s. Thermal latency (Delta temperature and duration) was the greatest for RFs at 90 W/4 s, followed by 50 W/10 s, and the smallest for 30 W/30 s (P= 50 degrees C at 3-mm depth) was observed after RF termination in 88.0 +/- 7.6% with 90 W/4 s, 57.7 +/- 14.6% with 50 W/10 s, and only 31.9 +/- 8.5% with 30 W/30 s (P