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

Autor:	Williams SE; Division of Imaging Sciences and Biomedical Imaging, King's College London, London, United Kingdom. Electronic address: steven.e.williams@kcl.ac.uk., Harrison J; Division of Imaging Sciences and Biomedical Imaging, King's College London, London, United Kingdom., Chubb H; Division of Imaging Sciences and Biomedical Imaging, King's College London, London, United Kingdom., Bloch LØ; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Andersen NP; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Dam H; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Karim R; Division of Imaging Sciences and Biomedical Imaging, King's College London, London, United Kingdom., Whitaker J; Division of Imaging Sciences and Biomedical Imaging, King's College London, London, United Kingdom., Gill J; Cardiovascular Division, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom., Cooklin M; Cardiovascular Division, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom., Rinaldi CA; Cardiovascular Division, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom., Rhode K; Division of Imaging Sciences and Biomedical Imaging, King's College London, London, United Kingdom., Wright M; Division of Imaging Sciences and Biomedical Imaging, King's College London, London, United Kingdom., Schaeffter T; Division of Imaging Sciences and Biomedical Imaging, King's College London, London, United Kingdom., Kim WY; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Jensen H; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Razavi R; Division of Imaging Sciences and Biomedical Imaging, King's College London, London, United Kingdom., O'Neill MD; Division of Imaging Sciences and Biomedical Imaging, King's College London, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	JACC. Clinical electrophysiology [JACC Clin Electrophysiol] 2015 Oct; Vol. 1 (5), pp. 421-431. Date of Electronic Publication: 2015 Aug 20.
DOI:	10.1016/j.jacep.2015.06.003
Abstrakt:	Objectives: 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. Background: 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. Methods: 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. Results: 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 (assessed by low-voltage criteria and late gadolinium enhancement signal intensity) or histological transmurality between high and low CF regions. Conclusions: Although high CF (>20 g) resulted in more acute tissue edema than low CF (<10 g), chronically there was no difference in lesion size, quality, or transmurality. Appropriate CF targets for atrial ablation may be lower than previously thought. (Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu