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- Title
Ambient circulation surrounding an ablation catheter tip affects ablation lesion characteristics.
- Authors
Nussinovitch, Udi; Wang, Paul; Babakhanian, Meghedi; Narayan, Sanjiv M.; Viswanathan, Mohan; Badhwar, Nitish; Zheng, Lijun; Sauer, William H.; Nguyen, Duy T.
- Abstract
Introduction: The association between ambient circulating environments (CEs) and ablation lesions has been largely underexplored. Methods: Viable bovine myocardium was placed in a saline bath in an ex vivo endocardial model. Radiofrequency (RF) ablation was performed using three different ablation catheters: 3.5 mm open irrigated (OI), 4, and 8 mm. Variable flow rates of surrounding bath fluids were applied to simulate standard flow, high flow, and no flow. For in vivo epicardial ablation, 24 rats underwent a single OI ablation and performed with circulating saline (30 ml/min; n = 12), versus those immersed in saline without circulation (n = 12). Results: High flow reduced ablation lesion volumes for all three catheters. In no‐flow endocardial CE, both 4 mm and OI catheters produced smaller lesions compared with standard flow. However, the 8 mm catheter produced the largest lesions in a no‐flow CE. Ablation performed in an in vivo model with CE resulted in smaller lesions compared with ablation performed in a no‐flow environment. No statistically significant differences in steam pops were found among the groups. Conclusion: A higher endocardial CE flow can decrease RF effectiveness. Cardiac tissue subjected to no endocardial CE flow may also limit RF for 4 mm catheters, but not for OI catheters; these findings may have implications for RF ablation safety and efficacy, especially in the epicardial space without circulating fluid or in the endocardium under varying flow conditions.
- Subjects
BIOLOGICAL models; CATTLE; MYOCARDIUM; IN vivo studies; RADIO frequency therapy; ANIMAL experimentation; CATHETER ablation; TREATMENT effectiveness; PRODUCT design; DESCRIPTIVE statistics; ENDOCARDIUM; ABLATION techniques; DOGS; PHYSIOLOGIC salines; CATHETERS
- Publication
Journal of Cardiovascular Electrophysiology, 2023, Vol 34, Issue 4, p918
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.15874