Effect of Baseline Impedance in Radiofrequency Delivery on Lesion Characteristics and the Relationship Between Impedance and Steam Pops.
Effect of Baseline Impedance in Radiofrequency Delivery on Lesion Characteristics and the Relationship Between Impedance and Steam Pops.
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DOI：
10.3389/fcvm.2022.872961
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发表时间：
2022
影响因子：
3.6
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中科院分区：
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探索基线阻抗（R）和功率（P）对射频消融（RFA）损伤特征的影响及其与使用ThermoCool SmartTouch-SF（STSF）导管在猪心脏中进行蒸汽爆裂的相关性。将猪左心室浸没在离体的37°C盐水中，并且用各种P（P = 30、40、50和60 W）和多个R负载（R = 80-100、100-140、140-180和180-220 Ω），以达到目标消融指数（AI; AI = 350、450和500）或使用固定贴靠力达到目标消融时间（CF; CF = 10-15 g）和相同的盐水冲洗（30 W/8 ml/min或40-60 W/15 ml/min），在每种条件下重复5次。病变的表面直径、最大直径、深度和体积与AI（P = 40 W，R = 100-140 Ω，CF = 10-15 g）密切相关（分别为r = 0.5412; r = 0.7889; r = 0.9366;和r = 0.913;所有p < 0.05）。随着R值的增加，病变的最大直径、深度和体积显著增加（AI = 350，P = 30 W）。R基线值越高，R下降的绝对值越大（r = 0.9035，p < 0.05，Y = 0.2759 × X - 18.33）。在高功率和高阻抗下，蒸汽爆裂的发生率较高（P = 60 W，R = 180-220 Ω，蒸汽爆裂发生时的AI：480 ± 26.5，消融时间：11.29 ± 1.04 s）。功率控制模式下的射频导管消融（RFCA）导致与不同基线Rs相关的各种病变特征。此外，蒸汽爆裂的发生率与高基线R和高P密切相关。
To explore the effects of baseline impedance (R) and power (P) on radiofrequency ablation (RFA) lesion characteristics and their correlation with steam pops using ThermoCool SmartTouch-SF (STSF) catheters in the porcine heart. A porcine left ventricle was submerged in 37°C saline ex vivo, and the experiment was performed with various P (P = 30, 40, 50, and 60 W) and multiple R loads (R = 80–100, 100–140, 140–180, and 180–220 Ω) to reach the target ablation index (AI; AI = 350, 450, and 500) or reach the target ablation time using a fixed contact force (CF; CF = 10–15 g) and the same saline irrigation (30 W/8 ml/min or 40–60 W/15 ml/min), repeated five times under each condition. The surface diameter, maximum diameter, depth, and volume of the lesions were strongly correlated with the AI (P = 40 W, R = 100–140 Ω, CF = 10–15 g) (r = 0.5412; r = 0.7889; r = 0.9366; and r = 0.913, respectively; all p < 0.05). As the value of R increased, the maximum diameter, depth, and volume of the lesions significantly increased (AI = 350, P = 30 W). Moreover, the higher the baseline value of R, the greater the absolute value of the R decrease (r = 0.9035, p < 0.05, Y = 0.2759 × X – 18.33). Under high power and high impedance, the occurrence rate of steam pops was high (P = 60 W, R = 180–220 Ω, AI when a steam pop occurred: 480 ± 26.5, ablation time: 11.29 ± 1.04 s). Radiofrequency catheter ablation (RFCA) in power-controlled mode resulted in various lesion characteristics that were related to diverse baseline Rs. In addition, the incidence of steam pops was strongly correlated with high baseline R and high P.