The force stability of tissue contact and lesion size index during radiofrequency ablation: An ex-vivo study
The force stability of tissue contact and lesion size index during radiofrequency ablation: An ex-vivo study
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DOI：
10.1111/pace.13891
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发表时间：
2020-03-01
影响因子：
1.8
通讯作者：
Boldt, Leif-Hendrik
中科院分区：
文献类型：
--
作者：
Parwani, Abdul S.;Hohendanner, Felix;Boldt, Leif-Hendrik
射频消融是侵入性电生理实验室治疗各种节律障碍的常用工具。可靠地创建跨壁消融病灶是长期成功的关键。病变大小指数（LSI）是一个多参数指数，将射频消融过程中记录的时间、功率、接触力（CF）和阻抗数据纳入加权公式，并已被证明可以预测心肌组织病变的程度。在lsi引导下的消融中，接触的力稳定性是否会影响病灶的大小尚不清楚。目的在离体模型中分析lsi引导消融过程中接触力稳定性对病灶大小的影响。方法和结果：在猪心肌板上使用开头冲洗消融导管，在以下设置下，共产生267个射频病变（n = 6个心脏）：35w，间歇（0至20g不等），可变（10至20g），或以垂直或平行的方式（手动施加）恒定组织接触（15g），直至目标LSI为5或6。随后，确定病变宽度和深度。病变宽度主要受导管尖端定向和LSI的影响，而病变深度主要受单独LSI的影响。导管接触力稳定性对病变宽度和深度无影响。结论导管接触力稳定性对超声引导下导管消融术中病灶深度和宽度的影响较小，导管定位对病灶宽度的影响较大。
Introduction Radiofrequency (RF) ablation is a commonly used tool in the invasive electrophysiology laboratory to treat a variety of rhythm disorders. Reliable creation of transmural ablation lesions is crucial for long-term success. Lesion size index (LSI) is a multiparametric index that incorporates time, power, contact force (CF), and impedance data recorded during RF ablation in a weighted formula and has been shown to predict the extent of myocardial tissue lesions. Whether the force stability of contact influences lesion size in LSI-guided ablations is unknown.Objectives The aim of this study was to analyze the influence of the force stability of contact on lesion size during LSI-guided ablations in an ex-vivo model.Methods and Results A total of 267 RF lesions (n = 6 hearts) were created on porcine myocardial slabs by using an open-tip irrigated ablation catheter with the following settings: 35 W with either intermittent (varied between 0 and up to 20 g), variable (10 to 20 g), or constant tissue contact (15 g) in a perpendicular or parallel fashion (applied manually) up to a target LSI of either 5 or 6. Subsequently, lesion width and depth were determined. Lesion width was mainly influenced by catheter tip orientation and LSI, whereas lesion depth was mainly influenced by LSI alone. The force stability of catheter contact had no relevant impact on lesion width or depth.Conclusion The force stability of catheter contact has only little effect on lesion depth or width in LSI-guided catheter ablation while the catheter orientation primarily affects lesion width.