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Bipolar ablation with contact force‐sensing of swine ventricles shows improved acute lesion features compared to sequential unipolar ablation
- Source :
- Journal of Cardiovascular Electrophysiology. 31:1128-1136
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Introduction Despite technical progress, ventricular tachycardia (VT) recurrence after unipolar ablation remains relatively high (12%-47%). Bipolar ablation has been proposed as an appealing solution that may overcome limitations associated with unipolar ablation settings. We designed an animal study to compare bipolar (BPA) vs sequential unipolar ablation (UPA) using contact force-sensing technology on both ablation catheters. Methods Twenty large white female pigs (6-months-old, 50-60 kg) underwent multiple RF ablations (30 W, 60 seconds, 30 mL/min irrigation) on the ventricular myocardium from the epicardial and endocardial sides. The hearts were fixed and scanned with high-resolution cardiac magnetic resonance imaging. Thermal lesions were located and characterized in volume, depth, width, and transmurality. Results Lesion volume was calculated as the sum of epicardial or endocardial conjoined/isolated lesions at one location. Linear dimensions (width and depth) were measured twice for each location, on the endocardial and epicardial side. We evaluated 35 lesions across the intraventricular septum (UPA, N = 17 vs BPA, N = 18). No difference in volume, linear dimensions or impedance drop was observed in this area between UPA and BPA. However, BPA required half RF time and showed an increased transmurality trend. We then analyzed 73 lesions from the endocardial side (UPA, N = 35 vs BPA, N = 38) and 50 from the epicardial side (UPA, N = 11 vs BPA N = 39) of the ventricular free walls. Lesion transmurality was markedly improved by BPA (P = .030, odds ratio, 23.73 [4.71,31.96]). Ventricular BPA lesions were significantly deeper on the epicardial side (P < .0001) and endocardial side (P = .015). Conclusion Bipolar ablation is more likely to create transmural and epicardial lesions in the ventricle wall. Half the time is needed for the creation of comparably deep and large lesions.
- Subjects :
- Heart Ventricles
medicine.medical_treatment
Sus scrofa
030204 cardiovascular system & hematology
Ventricular tachycardia
Cardiac Catheters
Lesion
03 medical and health sciences
0302 clinical medicine
Cardiac magnetic resonance imaging
Physiology (medical)
Transducers, Pressure
Animals
Medicine
Animal study
030212 general & internal medicine
medicine.diagnostic_test
business.industry
Myocardium
Bipolar ablation
Large white
Equipment Design
Ablation
medicine.disease
Magnetic Resonance Imaging
medicine.anatomical_structure
Ventricle
Catheter Ablation
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Nuclear medicine
Subjects
Details
- ISSN :
- 15408167 and 10453873
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiovascular Electrophysiology
- Accession number :
- edsair.doi.dedup.....32e7e27f276e9ee434b0418df141973f