Importance of Catheter Contact Force During Irrigated Radiofrequency Ablation: Evaluation in a Porcine Ex Vivo Model Using a Force-Sensing Catheter
Importance of Catheter Contact Force During Irrigated Radiofrequency Ablation: Evaluation in a Porcine Ex Vivo Model Using a Force-Sensing Catheter
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DOI：
10.1111/j.1540-8167.2009.01693.x
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发表时间：
2010-07-01
影响因子：
2.7
通讯作者：
Reddy, Vivek Y.
中科院分区：
文献类型：
--
作者：
Thiagalingam, Aravinda;D'Avila, Andre;Reddy, Vivek Y.
方法和结果：在离体模型中，使用新鲜的肝素化氧合猪血对11只雄性猪的新鲜离体心脏进行灌注和灌流。使用3种不同的功率控制策略（阻抗控制-15目标阻抗下降，20 W或30 W固定功率）和3种不同的贴靠力（2 g、20 g和60 g）进行1分钟消融，得到9个消融组的网格。所有消融均以17 mL/min的速度灌注力传感导管（Tacticath（TM），Endosense SA）。在总共101次消融中，未观察到血栓形成，但在17处病变中观察到爆裂。15、20 W和30 W组的损伤深度和爆裂发生率分别为5.0 ± 1.3 mm /0%、5.0 ± 1.6 mm /10%和6.7 ± 2.5 mm /45% 2 g、20 g和60 g组分别为4.4 ± 1.8 mm /3%、5.8 ± 1.6 mm /17%和6.6 ± 2.0 mm /37%（P < 0.01）。前5秒内的阻抗下降与导管贴靠力显著相关：2 g、20 g和60 g组分别为9.7 +/- 9.9、22.3 +/- 11.0和41.7 +/- 22.1结论：导管贴靠力对消融灶的大小和爆裂的发生率有重要影响。（J J.E. Vasc Electrophysiol，Vol. pp. 806-811，2010年7月）。
Methods and Results: Freshly excised hearts from 11 male pigs were perfused and superfused using fresh, heparinized, oxygenated swine blood in an ex vivo model. One-minute ablations were placed using one of 3 different power control strategies (impedance control-15 target impedance drop, and 20 W or 30 W fixed power) and 3 different contact forces (2 g, 20 g, and 60 g) to give a grid of 9 ablation groups. The force sensing catheter (Tacticath (TM), Endosense SA) was irrigated at 17 mL/min for all of the ablations.Of a total 101 ablations, no thrombus formation was noted but popping was seen in 17 lesions. The lesion depth and incidence of pops was 5.0 +/- 1.3 mm /0%, 5.0 +/- 1.6 mm /10% and 6.7 +/- 2.5 mm /45% for the 15 , 20 W, and 30 W groups (P < 0.01), respectively, and 4.4 +/- 1.8 mm /3%, 5.8 +/- 1.6 mm /17% and 6.6 +/- 2.0 mm /37% for the 2 g, 20 g, and 60 g groups, respectively (P < 0.01). The impedance drop in the first 5 seconds was significantly correlated to catheter contact force: 9.7 +/- 9.9 , 22.3 +/- 11.0 , and 41.7 +/- 22.1 , respectively, for the 2 g, 20 g, and 60 g groups (Pearson's r = 0.65, P < 0.01).Conclusion: Catheter contact force has an important impact on both ablation lesion size and the incidence of pops. (J Cardiovasc Electrophysiol, Vol. pp. 806-811, July 2010).