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- Title
In Vitro Evaluation of Ice-Cold Saline Irrigation During Catheter Radiofrequency Ablation.
- Authors
SQUARA, FABIEN; MAEDA, SHINGO; ALDHOON, BASHAR; MARGINIERE, JULIE; SANTANGELI, PASQUALE; CHIK, WILLIAM W.; MICHELE, JOHN; ZADO, ERICA; MARCHLINSKI, FRANCIS E.
- Abstract
In Vitro Evaluation of Ice-Cold Saline Irrigation Introduction Irrigated radiofrequency (RF) catheters allow tissue-electrode interface cooling, decreasing thrombus risk while enabling higher RF power delivery. The impact of irrigation with ice-cold saline (ICS) instead of conventional ambient-temperature saline (ATS) on lesion formation is unknown. Methods and Results We performed 120 RF ablations in vitro on porcine left ventricles, using ICS (<5 °C) or ATS (21 °C) irrigation. For ICS irrigation, the irrigation circuit was cooled externally to maintain delivery of cooled saline at the catheter's tip. We applied 20 g of contact force, and delivered 20 W (irrigation 8 or 17 mL/min) or 30 W (irrigation 17 or 30 mL/min) RF power. Temperatures at tissue-electrode interface and 3-mm depth were assessed by fluoroptic probes. Lesion dimensions were assessed. ICS irrigation cooled the tissue-electrode interface better than ATS (53.9 ± 9.6 °C vs. 63 ± 11.4 °C, P < 0.001). Temperatures at 3-mm depth were similar at 30 W using ICS and ATS (104.2 ± 9.3 °C vs. 105.8 ± 7.3 °C, P = 0.5), but were cooler at 20 W using ICS (71.3 ± 11.6 °C vs. 100.2 ± 11.9 °C, P < 0.001). This translated into smaller lesions at 20 W with ICS versus ATS. At 30 W with 17 mL/min flow rate, lesions had the same depth with ICS and ATS (4.9 ± 0.8 mm vs. 5.4 ± 0.7 mm, P = 0.13) but were narrower with ICS (7.7 ± 0.8 mm vs. 9.3 ± 1.2 mm, P = 0.001). At 30 mL/min, lesions had the same dimensions. Steam pop rate was similar using ICS or ATS irrigation. Conclusion ICS irrigation more effectively cools tissue-electrode interface than ATS. This may improve RF safety by potentially decreasing thrombus formation, thus facilitating safe ablation at a low saline volume load. However at lower RF power, ICS reduced lesion size compared to ATS.
- Subjects
IRRIGATION (Medicine); THROMBOSIS prevention; CATHETER ablation; ANIMAL experimentation; COLD (Temperature); PHYSIOLOGIC salines; RESEARCH funding; SWINE; THROMBOSIS; DESCRIPTIVE statistics; IN vitro studies; MANN Whitney U Test
- Publication
Journal of Cardiovascular Electrophysiology, 2014, Vol 25, Issue 10, p1125
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.12479