Contact-force recovery predicts the absence of cardiac perforation during steam pops.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
Anand GanapathyMehdi Razavi

Abstract

Cardiac perforation (CP) is an uncommon but clinically important complication of radiofrequency ablation (RFA). We previously showed that contact-force recovery after a steam pop predicts the absence of CP in an open-chest animal model after pericardial dissection. We attempted to determine whether this also applies when pericardium is present. In 5 open-chest sheep, left atrial RFA was performed under direct observation with a 7.5F ThermoCool SmartTouch force-sensing catheter (Biosense Webster Inc., Irvine, CA, USA). The catheter's contact force was measured every 50 ms during RFA. After each steam pop, the presence (+) or absence (-) of CP was noted, as well as whether pericardium was present over the ablation site. Contact-force signals were analyzed to detect contact-force recovery. Perforation rates were compared between sites with or without pericardium. Ninety-six steam pops occurred: 77 with pericardium and 19 without. For the pericardial steam pops, contact-force recovery occurred in 31/60 CP- events (52%) and 1/17 CP+ events (6%; P = 0.0006). For nonpericardial steam pops, contact-force recovery occurred in 4/9 CP- events (44%) and 1/10 CP+ events (P = 0.14). The rate of CP was 22% with pericardium and 52% without (P ...Continue Reading

References

Mar 10, 2000·Pacing and Clinical Electrophysiology : PACE·O J EickB Schumacher
Jul 15, 2011·Circulation. Arrhythmia and Electrophysiology·Michifumi TokudaRoy M John
Jul 11, 2012·Circulation·Roderick TungKalyanam Shivkumar
Jun 12, 2013·Journal of Cardiovascular Electrophysiology·Jacob S KoruthVivek Y Reddy
May 7, 2014·Pacing and Clinical Electrophysiology : PACE·Alireza NazeriMehdi Razavi
Dec 18, 2014·Journal of Cardiovascular Electrophysiology·William W B ChikAravinda Thiagalingam

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Citations

Apr 23, 2021·Expert Review of Medical Devices·Weyland ChengPenggao Wang

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