Comparison of three different approaches to very high‐power short‐duration ablation using the QDOT‐MICRO catheter
Comparison of three different approaches to very high‐power short‐duration ablation using the QDOT‐MICRO catheter
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使用 QDOT-MICRO 导管进行极高功率短时消融的三种不同方法的比较
DOI：
10.1111/jce.15875
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发表时间：
2023
影响因子：
2.7
通讯作者：
Sasano Tetsuo
中科院分区：
文献类型：
--
作者：
Yamaguchi Junji;Takigawa Masateru;Goya Masahiko;Martin Claire A.;Yamamoto Tasuku;Ikenouchi Takashi;Shigeta Takatoshi;Nishimura Takuro;Tao Susumu;Miyazaki Shinsuke;Sasano Tetsuo
背景/目的QDOT‐MICRO™导管允许进行极高功率短持续时间（vHPSD）消融。本研究旨在研究病变特征，使用不同的消融settings. MethodsRadiotherapy的应用程序（90 W/4秒，温度控制模式与55°C或60°C的目标）进行切除猪心肌使用三种不同的方法：单（SA），双非重复（DNRA），和双重复应用程序（ESTA）。应用程序进行了DNRA的间隔为1分钟，没有间隔的cardiovascular.ResultsA共480病变进行了分析。无论导管方向如何，经皮穿刺的病变深度和体积最大，其次是DNRA和SA（深度：3.8 vs. 3.3 vs. 2.6 mm，所有比较p<0.001;体积：176.6 vs. 145.1 vs. 97.0 mm 3，所有比较p<0.001）。表面积方面，骨水泥组显著大于SA组（45.1 vs. 38.3 mm 2，p<0.001），DNRA组显著大于SA组（44.5 vs. 38.3 mm 2，p<0.001），但骨水泥组和DNRA组相似（45.1 vs. 44.5 mm 2，p= 0.54）。蒸汽爆裂的发生率在SA组（15.6% vs. 4.4%，p = .004）和DNRA组（15.6% vs. 6.9%，p = .061）中更高，但SA和DNRA的发生率相似（4.4% vs. 6.9%，p = 1）。尽管有蒸汽爆破的病变的表面积和病变体积大于无蒸汽爆破的病变，（分别为46.5 vs. 38.1 mm 2，p= 0.018和128.3 vs. 96.8 mm 3，p= 0.068），病变不深（爆裂（+）：2.5 mm vs.爆裂（-）：2.6 mm，p= 0.75）。结论DNRA产生的病变比SA更大，而不会增加蒸汽爆裂的风险。在三组中，血管紧张素转换酶产生的病变最大，但蒸汽爆裂的风险增加。即使使用蒸汽爆破，vHPSD消融中的损伤也不会变得更深。
Background/ObjectivesThe QDOT‐MICRO™ catheter allows very high‐power and short‐duration (vHPSD) ablation. This study aimed to investigate lesion characteristics using different ablation settings.MethodsRadiofrequency applications (90 W/4 s, temperature‐control mode with 55°C or 60°C target) were performed in excised porcine myocardium using three different approaches: single (SA), double nonrepetitive (DNRA), and double repetitive applications (DRA). Applications were performed with an interval of 1 min for DNRA, and without interval for DRA.ResultsA total of 480 lesions were analyzed. Lesion depth and volume were largest for DRA followed by DNRA and SA regardless of catheter direction (depth: 3.8 vs. 3.3 vs. 2.6 mm,p< .001 for all comparisons; volume: 176.6 vs. 145.1 vs. 97.0 mm3,p< .001 for all comparisons). Surface area was significantly larger for DRA than for SA (45.1 vs. 38.3 mm2,p< .001) and larger for DNRA than for SA (44.5 vs. 38.3 mm2,p< .001), but was similar between DRA and DNRA (45.1 vs. 44.5 mm2,p= .54). Steam‐pops more frequently occurred for DRA than for SA (15.6% vs. 4.4%,p= .004) and DNRA (15.6% vs. 6.9%,p= .061), but the incidence was similar between SA and DNRA (4.4% vs. 6.9%,p= 1). Although surface area and lesion volume were larger in lesions with steam‐pops than without steam‐pops (46.5 vs. 38.1 mm2,p= .018 and 128.3 vs. 96.8 mm3,p= .068, respectively), lesions were not deeper (pop(+): 2.5 mm vs. pop(−): 2.6 mm,p= .75).ConclusionsDNRA produces larger lesions than SA without increasing the risk of steam‐pops. DRA produces the largest lesions among the three groups, but with an increased risk of steam‐pops. Even with steam‐pops, lesions do not become deeper in vHPSD ablation.
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影响因子：
2.7
作者：
F. Wittkampf;H. Nakagawa;S. Foresti;H. Aoyama;W. Jackman
通讯作者：
W. Jackman
左心房壁厚度：与房颤导管消融相关的解剖学方面。
影响因子：
6.1
作者：
Hong;Xin;Hai;Li Zhou;Jia;Xu Liu
通讯作者：
Xu Liu
DOI：
10.1016/j.ijcha.2021.100847
发表时间：
2021-08
期刊：
International journal of cardiology. Heart & vasculature
影响因子：
--
作者：
Richard Tilz R;Sano M;Vogler J;Fink T;Saraei R;Sciacca V;Kirstein B;Phan HL;Hatahet S;Delgado Lopez L;Traub A;Eitel C;Schlüter M;Kuck KH;Heeger CH
通讯作者：
Heeger CH
影响因子：
8.4
作者：
Nakagawa, Hiroshi;Ikeda, Atsushi;Jackman, Warren M.
通讯作者：
Jackman, Warren M.
影响因子：
6.1
作者：
Halbfass, Philipp;Wielandts, Jean-Yves;Deneke, Thomas
通讯作者：
Deneke, Thomas