Comparison of lesion characteristics using temperature‐flow‐controlled versus conventional power‐controlled ablation with fixed ablation index
Comparison of lesion characteristics using temperature‐flow‐controlled versus conventional power‐controlled ablation with fixed ablation index
复制标题
使用温度流量控制消融与固定消融指数的传统功率控制消融的病变特征比较
DOI：
10.1111/jce.15883
复制
发表时间：
2023
影响因子：
2.7
通讯作者：
and other members of the Study Group
中科院分区：
文献类型：
--
作者：
Ikenouchi Takashi;Takigawa Masateru;Goya Masahiko;Martin Claire A.;Yamamoto Tasuku;Yamaguchi Junji;Goto Kentaro;Shigeta Takatoshi;Nishimura Takuro;Tao Susumu;Miyazaki Shinsuke;Sasano Tetsuo;and other members of the Study Group
引言QDOT‐ MicroTM导管是一种新型的灌注贴靠力（CF）传感导管，受益于热电偶进行温度监测，允许温度流量控制（TFC）消融。我们比较了TFC消融和常规功率控制（PC）消融期间固定消融指数（AI）值下的损伤度量。MethodsA共480次射频应用在离体猪心肌上进行，具有预定义的AI目标（400/550）或直到蒸汽爆裂发生，使用QDOT‐MicroTM（TFC-消融）和Thermocool SmartTouch SFTM结果TFC消融术和PC消融术在体积上产生相似的损伤（218 ± 116 vs. 212 ± 107 mm3，p= .65）;然而，使用TFC消融的病变表面积较大，（41.3 ± 8.8 vs. 34.8 ± 8.0 mm 2，p<0.001），深度较浅（4.0 ± 1.0 vs. 4.2 ± 1.1 mm，p= 0.044）。由于温度和灌注流量的自动调节，TFC消融的平均功率（34.2 ± 8.6 vs. 36.9 ± 9.2，p = 0.005）往往低于PC消融。尽管蒸汽爆裂在TFC消融中的发生率较低（24% vs. 15%，p = 0.021），但在PC消融（n= 24/240，10.0%）和TFC消融（n = 23/240，9.6%）中，在低CF（10 g）和高功率消融（50 W）中尤其观察到蒸汽爆裂。多变量分析显示，高功率、低CF、长应用时间、垂直导管方向和PC消融是蒸汽爆裂的风险因素。此外，激活温度和灌注流量的自动调节与高CF和长应用时间独立相关，而消融功率没有显著关系。结论：在固定目标AI的情况下，TFC消融降低了蒸汽爆裂的风险，产生了类似的体积损伤，但在这项体外研究中具有不同的指标。然而，固定人工智能消融中较低的CF和较高的功率可能会增加蒸汽爆裂的风险。
IntroductionThe QDOT‐MicroTMcatheter is a novel irrigated contact force (CF) sensing catheter which benefits from thermocouples for temperature monitoring, allowing temperature‐flow‐controlled (TFC) ablation. We compared lesion metrics at fixed ablation index (AI) value during TFC‐ablation and conventional power‐controlled (PC)‐ablation.MethodsA total of 480 RF‐applications were performed on ex‐vivo swine myocardium with predefined AI targets (400/550) or until steam‐pop occurred, using the QDOT‐MicroTM(TFC‐ablation) and Thermocool SmartTouch SFTM(PC‐ablation).ResultsBoth TFC‐ablation and PC‐ablation produced similar lesions in volume (218 ± 116 vs. 212 ± 107 mm3,p= .65); however, lesions using TFC‐ablation were larger in surface area (41.3 ± 8.8 vs. 34.8 ± 8.0 mm2,p< .001) and shallower in depth (4.0 ± 1.0 vs. 4.2 ± 1.1 mm,p= .044). Average power tended to be lower in TFC‐alation (34.2 ± 8.6 vs. 36.9 ± 9.2,p= .005) compared to PC‐ablation due to automatic regulation of temperature and irrigation‐flow. Although steam‐pops were less frequent in TFC‐ablation (24% vs. 15%,p= .021), they were particularly observed in low‐CF (10 g) and high‐power ablation (50 W) in both PC‐ablation (n= 24/240, 10.0%) and TFC‐ablation (n= 23/240, 9.6%). Multivariate analysis revealed that high‐power, low‐CF, long application time, perpendicular catheter orientation, and PC‐ablation were risk factors for steam‐pops. Furthermore, activation of automatic regulation of temperature and irrigation‐flow was independently associated with high‐CF and long application time while ablation power had no significant relationship.ConclusionsWith a fixed target AI, TFC‐ablation reduced the risk of steam‐pops, producing similar lesions in volume, but with different metrics in this ex‐vivo study. However, lower CF and higher power in fixed‐AI ablation may increase the risk of steam‐pops.
登录
查看更多内容
影响因子：
--
作者：
Pranata, Raymond;Vania, Rachel;Huang, Ian
通讯作者：
Huang, Ian
影响因子：
2.7
作者：
F. Wittkampf;H. Nakagawa;S. Foresti;H. Aoyama;W. Jackman
通讯作者：
W. Jackman
影响因子：
2
作者：
Mori, Hitoshi;Kato, Ritsushi;Matsumoto, Kazuo
通讯作者：
Matsumoto, Kazuo
影响因子：
2.7
作者：
Bourier, Felix;Popa, Miruna;Deisenhofer, Isabel
通讯作者：
Deisenhofer, Isabel
结合局部阻抗和常规参数的新公式对病灶大小预测的影响
DOI：
--
发表时间：
2020
期刊：
影响因子：
--
作者：
Takigawa M;Goya M,Iwakawa H;Kamata T;Matsumura Y;Amemiya M;Yamamoto T;Hirao T;Sekigawa M;Shirai Y;Tao S;Hayashi T;Takahashi Y,Sasano T
通讯作者：
Takahashi Y,Sasano T