Safe and effective delivery of high-power, short-duration radiofrequency ablation lesions with a flexible-tip ablation catheter.

Autor:	Ptaszek LM; Cardiac Arrhythmia Service, MGH Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Koruth J; Helmsley Electrophysiology Center, Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York., Santangeli P; Cardiac Electrophysiology Section, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania., Piccini JP; Electrophysiology Section, Duke University Hospital and Duke Clinical Research Institute, Durham, North Carolina., Ranjan R; Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah., Mahapatra S; M Health Fairview University of Minnesota, Minneapolis, Minnesota., Pipenhagen C; Abbott, Plymouth, Minnesota., Fish JM; Abbott, Plymouth, Minnesota., Moon LB; Abbott, Plymouth, Minnesota., Ambrosius NM; Abbott, Plymouth, Minnesota., Boudlali H; Abbott, Plymouth, Minnesota., Jensen JA; Abbott, Plymouth, Minnesota.
Jazyk:	angličtina
Zdroj:	Heart rhythm O2 [Heart Rhythm O2] 2022 Oct 25; Vol. 4 (1), pp. 42-50. Date of Electronic Publication: 2022 Oct 25 (Print Publication: 2023).
DOI:	10.1016/j.hroo.2022.10.009
Abstrakt:	Background: High-power, short-duration (HPSD) radiofrequency ablation (RFA) may reduce ablation time. Concerns that catheter-mounted thermocouples (TCs) can underestimate tissue temperature, resulting in elevated risk of steam pop formation, potentially limit widespread adoption of HPSD ablation. Objective: The purpose of this study was to compare the safety and efficacy of HPSD and low-power, long-duration (LPLD) RFA in the context of pulmonary vein isolation (PVI). Methods: An open-irrigated ablation catheter with a contact force sensor and a flexible-tip electrode containing a TC at its distal end (TactiFlex TM Ablation Catheter, Sensor Enabled TM , Abbott) was used to isolate the left pulmonary veins (PVs) in 12 canines with HPSD RFA (50 W for 10 seconds) and LPLD RFA (30 W for a maximum of 60 seconds). PVI was assessed at 30 minutes and 28 ± 3 days postablation. Computed tomographic scans were performed to assess PV stenosis after RFA. Lesions were evaluated with histopathology. Results: A total of 545 ablations were delivered: 252 with LPLD (0 steam pops) and 293 with HPSD RFA (2 steam pops) ( P = .501). Ablation time required to achieve PVI was >3-fold shorter for HPSD than for LPLD RFA ( P = .001). All 24 PVs were isolated 30 minutes after ablation, with 12/12 LPLD-ablated and 11/12 HPSD-ablated PVs still isolated at follow-up. Histopathology revealed transmural ablations for HPSD and LPLD RFA. No major adverse events occurred. Conclusion: An investigational ablation catheter effectively delivered RFA lesions. Ablation time required to achieve PVI with HPSD with this catheter was >3-fold shorter than with LPLD RFA. (© 2022 Heart Rhythm Society. Published by Elsevier Inc.)
Databáze:	MEDLINE
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