High-Volume Lesions Using a New Second-Generation Open Irrigation Radiofrequency Catheter Are Associated with the Development of Inhomogeneous Lesions

Autor:	Zsuzsanna Lendvai, Judit Skopál, Eszter M. Végh, Endre Zima, Béla Merkely, Martha Hubay, Gábor Széplaki, Tamas Szili-Torok, Dominic A.M.J. Theuns, Ferdi Akca
Rok vydání:	2014
Předmět:	medicine.medical_specialty business.industry medicine.medical_treatment Thigh muscle Histology Catheter ablation General Medicine Confidence interval Surgery Lesion Catheter Homogeneous medicine Multiple logistic regression analysis medicine.symptom Cardiology and Cardiovascular Medicine Nuclear medicine business
Zdroj:	Pacing and Clinical Electrophysiology. 37:864-873
ISSN:	0147-8389
DOI:	10.1111/pace.12359
Popis:	Background After catheter ablation there is often a discrepancy between acute and chronic success rates. We aimed to evaluate major determinants for lesion quality and understand different manifestations of lesion structures. Methods In a canine thigh muscle model radiofrequency (RF) current was delivered for 60 seconds at 30 W (n = 39) or 50 W (n = 18) with 15-g contact force. A second-generation 12-hole gold open irrigation catheter (SGIT) and a first-generation six-hole platinum-iridium catheter (FGIT; Biotronik, Berlin, Germany) were used. Electrode and tissue temperatures (at the surface and 3.5-mm and 7-mm depth) were recorded and lesion dimensions were measured. Lesions with steam pops were excluded. Histological examination was performed to evaluate homogeneity of the lesions. Inhomogeneity was defined as a visual multiband lesion pattern indicating different histological characteristics. Results In total 57 lesions were created. Seventeen lesions were excluded (steam pops) and 40 lesions were analyzed. A total number of 11 homogeneous and 29 inhomogeneous lesions were identified. Using the SGIT catheter 16.7% of the lesions was homogeneous and 83.3% inhomogeneous; for FGIT it was 43.8% and 56.2% (P = 0.065), respectively. Homogeneous lesions had lower volumes as compared to inhomogeneous lesions (514.0 ± 198.8 vs 914.8 ± 399.1 mm, P = 0.003). Multiple logistic regression analysis indicated that the SGIT catheter is a significant predictor for inhomogeneous lesions (odds ratio 6.5, 95% confidence interval 1.1–38.8; P = 0.040) independent from power setting and flow rate. Conclusions The development of inhomogeneous lesions after acute RF ablation is associated with higher lesion volumes and the use of the second-generation irrigation gold-tip catheter.
Databáze:	OpenAIRE
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