DOI: 10.1101/19008706Oct 15, 2019Paper

Mechanistic insights into heterogeneous radiofrequency ablation effects at the left atrial posterior wall during pulmonary vein isolation

MedRxiv : the Preprint Server for Health Sciences
David R Tomlinson

Abstract

Background: Independent investigations demonstrate greater radiofrequency (RF) ablation effects at left-sided left atrial posterior wall (LAPW) sites. Objective: To investigate mechanisms underlying RF ablation heterogeneity during contact-force (CF) and VISITAG Module (Biosense Webster)-guided pulmonary vein isolation (PVI). Methods: Consecutive patients undergoing PVI during atrial overdrive pacing comprised 2 cohorts: intermittent positive pressure ventilation (IPPV, 14-16/min, 6-8ml/kg); high frequency jet ventilation (HFJV, 150/min, Monsoon III, Acutronic). Temperature-controlled (17ml/min, 48oC) RF data was retrospectively assessed at first-annotated (target 15s) LAPW sites: 30W during IPPV; 20W at left-sided sites during HFJV. Results: Twenty-five and 15 patients underwent PVI during IPPV and HFJV, respectively. During IPPV, left versus right-sided median impedance drop (ImpD) was 13.6{Omega} versus 9.9{Omega} (p<0.0001) respectively and mean time to pure R unipolar electrogram (UE) morphology change 4.9s versus 6.7s (p=0.007) respectively. During HFJV, ImpD was greater at left-sided sites (9.7{Omega} versus 7.4{Omega}, p=0.21) and time to pure R UE significantly shorter: 4.3s versus 6.1s (p=0.02). Minimum case impedance...Continue Reading

Related Concepts

Related Feeds

BioRxiv & MedRxiv Preprints

BioRxiv and MedRxiv are the preprint servers for biology and health sciences respectively, operated by Cold Spring Harbor Laboratory. Here are the latest preprint articles (which are not peer-reviewed) from BioRxiv and MedRxiv.