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Biparietal bidirectional bipolar radiofrequency in hybrid cardiac ablation
- Source :
- Interact Cardiovasc Thorac Surg, Interactive Cardiovascular and Thoracic Surgery, 33(1), 34-42. Oxford University Press
- Publication Year :
- 2021
- Publisher :
- European Association for Cardio-Thoracic Surgery, 2021.
-
Abstract
- OBJECTIVESThe aim of this study was to evaluate the lesion size and depth of radiofrequency (RF) ablation in a simultaneous biparietal bidirectional bipolar (SBB) approach, compared to a simultaneous and staged unipolar and uniparietal bipolar setup [simultaneous uniparietal bipolar (SiUB) and staged uniparietal bipolar (StUB), respectively].METHODSFresh left atrial porcine tissue was mounted into the ABLA-BOX simulator. Different ablation approaches were tested: (i) SBB: a concept consisting of SBB endo-epicardial ablation, (ii) SiUB: simultaneous epicardial uniparietal bipolar and endocardial unipolar ablation and (iii) StUB: staged epicardial uniparietal bipolar and endocardial unipolar ablation. In the StUB setup, a 1-h interval between the epi-endo ablation was respected.RESULTSTransmural lesions were present in 90% of the bipolar biparietal ablations, yet no full transmurality was observed in the simultaneous nor in the staged unipolar with uniparietal bipolar ablation group. In SBB, the area and volume of the ablation lesions were smaller (523.33 mm2/mm and 52.33 mm3/mm, respectively) than in SiUB (588.17 mm2/mm and 58.81 mm3/mm, respectively) and StUB (583.76 mm2/mm and 58.37 mm3/mm, P = 0.044). Also, in SBB, the overall, epicardial and endocardial maximum diameters of the lesions (1.59, 1.57 and 1.52 mm; respectively) were smaller than in SiUB (2.38, 2.26 and 2.33 mm; respectively) and in StUB (2.36, 2.28 and 2.14 mm; respectively, all P CONCLUSIONSAlthough bipolar biparietal bidirectional RF ablation results in smaller lesions than uniparietal bipolar and unipolar ablation, their capacity to penetrate the tissue is much higher. Moreover, in uniparietal RF applications, the energy spreads in the superficial layers of the tissue but fails to penetrate. Therefore, the degree of transmurality is much higher when using such a ‘truly bipolar’ ablation approach.
- Subjects :
- Pulmonary and Respiratory Medicine
Swine
Radiofrequency ablation
medicine.medical_treatment
Catheter ablation
PULMONARY VEINS
In vitro simulation
030204 cardiovascular system & hematology
Bipolar ablation
law.invention
ENERGY
03 medical and health sciences
0302 clinical medicine
Image processing
law
Atrial Fibrillation
mental disorders
BEATING HEART
Animals
Medicine
Heart Atria
Endocardium
Adult Cardiac
business.industry
Atrial fibrillation
Cardiac Ablation
PERFORMANCE
Ablation
medicine.disease
Stub (electronics)
030228 respiratory system
MONOPOLAR
SAFETY
ATRIAL-FIBRILLATION
Catheter Ablation
Surgery
business
Nuclear medicine
Cardiology and Cardiovascular Medicine
Hybrid AF ablation
Subjects
Details
- Language :
- English
- ISSN :
- 15699293
- Database :
- OpenAIRE
- Journal :
- Interact Cardiovasc Thorac Surg, Interactive Cardiovascular and Thoracic Surgery, 33(1), 34-42. Oxford University Press
- Accession number :
- edsair.doi.dedup.....f81ef902acd11b242b06a85dbd39d1aa
- Full Text :
- https://doi.org/10.1093/icvts/ivab047