The Effect of Contact Force in Atrial Radiofrequency Ablation: Electroanatomical, Cardiovascular Magnetic Resonance, and Histological Assessment in a Chronic Porcine Model

JACC. Clinical Electrophysiology
Steven E WilliamsMark D O'Neill

Abstract

This study sought to determine the effect of contact force (CF) on atrial lesion size, quality, and transmurality by using a chronic porcine model of radiofrequency ablation. CF is a major determinant of ventricular lesion formation, but uncertainty exists regarding the most appropriate CF parameters to safely achieve permanent, transmural lesions in the atria. Intercaval linear ablation (30 W, 42°C, 17 ml/min irrigation) was performed in 8 Göttingen minipigs by using a force-sensing catheter with CF >20 g (high force) or <10 g (low force) at alternate ends of the line, separated by an intentional gap. Voltage mapping and cardiovascular magnetic resonance (CMR) imaging were performed pre-ablation, immediately after ablation, and at 2 months' post-procedure. Lesions were sectioned orthogonal to the axis of ablation to assess transmurality. Mean CF was 22.6 ± 11.4 g and 7.8 ± 4.0 g in the high and low CF regions. Acute tissue edema was greater with high CF, both caudally (7.0 mm vs. 4.6 mm; p = 0.016) and cranially (6.9 mm vs. 4.6 mm; p = 0.038). There was no difference in chronic lesion size (voltage mapping) or volume (late gadolinium enhancement CMR) between high and low CF regions. There was no difference in scar density (ass...Continue Reading

References

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Citations

Apr 15, 2018·Circulation. Arrhythmia and Electrophysiology·John WhitakerMark D O'Neill
Jan 10, 2018·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Tom De PotterEdward Duncan
Apr 28, 2018·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Louisa O'NeillSteven E Williams
Oct 31, 2018·Journal of Cardiovascular Electrophysiology·Kennosuke YamashitaRavi Ranjan
Apr 17, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Mikkel Giehm-ReeseJens Cosedis Nielsen
Apr 24, 2020·Journal of Cardiovascular Electrophysiology·Fabrizio R AssisHarikrishna Tandri
Aug 8, 2020·Journal of Cardiovascular Electrophysiology·Mark D O'Neill, Steven E Williams
Dec 4, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Louisa O'NeillSteven E Williams
Jan 30, 2018·Journal of Cardiovascular Electrophysiology·Mark O'Neill, Steven E Williams
Nov 25, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Christian Sohns, Philipp Sommer
May 8, 2021·Heart, Lung & Circulation·Thirakan RattanakositRajiv Mahajan

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