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- Title
Relationship between catheter forces, lesion characteristics, 'popping,' and char formation: experience with robotic navigation system.
- Authors
Di Biase L; Natale A; Barrett C; Tan C; Elayi CS; Ching CK; Wang P; Al-Ahmad A; Arruda M; Burkhardt JD; Wisnoskey BJ; Chowdhury P; De Marco S; Armaganijan L; Litwak KN; Schweikert RA; Cummings JE
- Abstract
INTRODUCTION: Popping, char and perforation are complications that can occur following catheter ablation. We measured the amount of grams (g) applied to the endocardium during ablation using a sensor incorporated in the long sheath of a robotic system. We evaluated the relationship between lesion formation, pressure, and the development of complications. METHODS: Using a robotic navigation system, lesions were placed in the left atrium (LA) at six settings, using a constant duration (40 seconds) and flow rate of either 17 cc/min or 30 cc/min with an open irrigated catheter (OIC). Evidence of complications was noted and lesion location recorded for later analysis at necropsy. RESULTS: Lesions using 30 Watts (W) were more likely to be transmural at higher (>40 g) than lower (<30 g) pressures (75% vs 25%, P < 0.001). Significantly higher number of lesions using >40 g of pressure demonstrated 'popping' and crater formation as compared with lesions with 20-30 g of pressure (41% vs 15%, P = 0.008). A majority of lesions placed using higher power (45 W) with higher pressures (>40 g) were associated with char and crater formation (66.7%). No lesions using 10 g of pressure were transmural, regardless of the power. Lesions placed with a power setting less than 35 W were more likely to result in 'relative' sparing of the endocardial surface than lesions at a power setting higher than 35 W (62% vs 33.3%, P = 0.02) regardless of the pressure. CONCLUSIONS: When using an OIC, lower power settings (<or=35 W) and lower/medium contact pressure were more likely to show a 'relative' spared endocardial surface. Overall, contact pressure between 20 g and 30 g and a power setting of 40 W appeared to achieve transmurality by preserving safety.
- Publication
Journal of Cardiovascular Electrophysiology, 2009, Vol 20, Issue 4, p436
- ISSN
1045-3873
- Publication type
Journal Article
- DOI
10.1111/j.1540-8167.2008.01355.x