1. In vivo tissue temperatures during 90 W/4 sec‐very high power‐short‐duration (vHPSD) ablation versus ablation index‐guided 50 W‐HPSD ablation: A porcine study
- Author
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Naoto Otsuka, Yasuo Okumura, Sayaka Kuorkawa, Koichi Nagashima, Yuji Wakamatsu, Satoshi Hayashida, Kimie Ohkubo, Toshiko Nakai, Hiroyuki Hao, Rie Takahashi, and Yoshiki Taniguchi
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Neither the actual in vivo tissue temperatures reached with 90W/4sec-very high-power short-duration (vHPSD) ablation for atrial fibrillation nor the safety and efficacy profile have been fully elucidated.We conducted a porcine study in which, after right thoracotomy, we implanted 6-8 thermocouples epicardially in the superior vena cava, right pulmonary vein, and esophagus close to the inferior vena cava. We compared tissue temperatures close to a QDOT MICRO catheter, between during 90W/4sec-vHPSD ablation during ablation index (AI: target 400)-guided 50W-HPSD ablation, both targeting a contact force of 8-15 g.Maximum tissue temperature reached during 90W/4sec-vHPSD ablation did not differ significantly from that during 50W-HPSD ablation (49.2±8.4ºC versus 50.0±12.1ºC; P=0.69) and correlated inversely with distance between the catheter tip and the thermocouple, regardless of the power settings (r=-0.52 and r=-0.37). Lethal temperature (≥50°C) was best predicted at a catheter tip-to-thermocouple distance cut-point of 3.13 and 4.27 mm, respectively. All lesions produced by 90W/4sec-vHPSD or 50W-HPSD ablation were transmural. Although there was no difference in the esophageal injury rate (50% versus 66%, P=0.80), the thermal lesion was significantly shallower with 90W/4sec-vHPSD ablation than with 50W-HPSD ablation (381.3±127.3 versus 820.0±426.1μm from the esophageal adventitia; P=0.039).Actual tissue temperatures reached with 90W/4sec-vHPSD ablation appear similar to those with AI-guided 50W-HPSD ablation, with the distance between the catheter tip and target tissue being shorter for the former. Although both ablation settings may create transmural lesions in thin atrial tissues, any resulting esophageal thermal lesions appear shallower with 90W/4sec-vHPSD ablation. This article is protected by copyright. All rights reserved.
- Published
- 2022