Higher contact force during radiofrequency ablation leads to a much larger increase in edema as compared to chronic lesion size

Journal of Cardiovascular Electrophysiology
Samuel ThomasRavi Ranjan

Abstract

Reversible edema is a part of any radiofrequency ablation but its relationship with contact force is unknown. The goal of this study was to characterize through histology and MRI, acute and chronic ablation lesions and reversible edema with contact force. In a canine model (n = 14), chronic ventricular lesions were created with a 3.5-mm tip ThermoCool SmartTouch (Biosense Webster) catheter at 25 W or 40 W for 30 seconds. Repeat ablation was performed after 3 months to create a second set of lesions (acute). Each ablation procedure was followed by in vivo T2-weighted MRI for edema and late-gadolinium enhancement (LGE) MRI for lesion characterization. For chronic lesions, the mean scar volumes at 25 W and 40 W were 77.8 ± 34.5 mm3 (n = 24) and 139.1 ± 69.7 mm3 (n = 12), respectively. The volume of chronic lesions increased (25 W: P < 0.001, 40 W: P < 0.001) with greater contact force. For acute lesions, the mean volumes of the lesion were 286.0 ± 129.8 mm3 (n = 19) and 422.1 ± 113.1 mm3 (n = 16) for 25 W and 40 W, respectively (P < 0.001 compared to chronic scar). On T2-weighted MRI, the acute edema volume was on average 5.6-8.7 times higher than the acute lesion volume and increased with contact force (25 W: P = 0.001, 40 W: P =...Continue Reading

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Oct 1, 2015·JACC. Clinical Electrophysiology·Ravi Ranjan

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Citations

Oct 31, 2018·Journal of Cardiovascular Electrophysiology·Kennosuke YamashitaRavi Ranjan
Feb 23, 2020·JACC. Clinical Electrophysiology·Kennosuke YamashitaRavi Ranjan

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