Comparison of ablation index versus time-guided radiofrequency energy dosing using normal and half-normal saline irrigation in a porcine left ventricular model.
J Cardiovasc Electrophysiol
; 33(4): 698-712, 2022 04.
Article
en En
| MEDLINE
| ID: mdl-35048448
ABSTRACT
BACKGROUND:
Ablation Index (AI) is a multiparametric quality marker to assess the durability of radiofrequency (RF) lesions. The comparative effectiveness and safety of AI versus time-based energy dosing for ablation of ventricular arrhythmias are unknown.OBJECTIVE:
We compared AI and time-based RF dosing strategies in the left ventricles (LVs) of freshly harvested porcine hearts.METHODS:
Ablation was performed in vitro with an open-irrigated ablation catheter (Thermocool ST/SF), 40 W, contact force 10-15 g. Tissue samples were stained in triphenyltetrazolium chloride for the measurement of lesion dimensions.RESULTS:
A total of 560 lesions were performed (AI-group [n = 360]; time-group [n = 200]). Using normal saline (NS) (n = 280), growth in lesion depth slowed after 30 s and AI > 550 in comparison to width, volume, and magnitude of impedance drops which continued to increase with longer RF duration. Risk of steam pop (SP) was higher for RF > 30 s (RF < 30 s1 SP [2.5%] vs. RF > 30 s 15 SP [25%]; p = .002) or AI targets >550 (AI 350-550 2 SP [2%] vs. AI 600-750 15 SP [19%]; p = .001). Using half-normal saline (HNS) (n = 280), lesion dimension and impedance drops were larger and growth in lesion depth slowed earlier (AI 500). Risk of SPs was higher above AI 550 (AI 350-550 7 [7%] SPs vs. AI 600-750 28 [35%] SPs; p < .00001). While codependent variables, correlation between AI and time was modest-to-strong but decreased with longer RF duration.CONCLUSION:
In this ex vivo study, AI was a better predictor of lesion dimensions than ablation time and magnitude of impedance drop in the LV using NS and HNS irrigation. AI targets above 550 led to a higher risk of SPs. Future trials are required to verify these findings.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Ablación por Catéter
/
Solución Salina
Tipo de estudio:
Prognostic_studies
Límite:
Animals
Idioma:
En
Revista:
J Cardiovasc Electrophysiol
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
FISIOLOGIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Estados Unidos