Optimal interlesion distance for 90 and 50 watt radiofrequency applications with low ablation index values: experimental findings in a chronic ovine model.
| Title: | Optimal interlesion distance for 90 and 50 watt radiofrequency applications with low ablation index values: experimental findings in a chronic ovine model. |
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| Authors: | Bortone AA; ELSAN, Service de Cardiologie, Hôpital Privé Les Franciscaines, 3 Rue Jean Bouin, 30000 Nîmes, France.; Ramirez FD; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.; Constantin M; L'Institut de RYthmologie et modélisation Cardiaque (LIRYC), Université de Bordeaux, 33600 Pessac, France.; Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, 33600 Pessac, France.; Bortone C; Faculté de Médecine, Université de Montpellier, Montpellier, France.; Hébert C; Biosense-Webster France, Johnson & Johnson, 92787 Issy-les-Moulineaux, France.; Constantin J; Biosense-Webster France, Johnson & Johnson, 92787 Issy-les-Moulineaux, France.; Bialas P; Department of Anesthesiology, Saarland Medical University, Homburg, Germany.; Limite LR; ELSAN, Service de Cardiologie, Hôpital Privé Les Franciscaines, 3 Rue Jean Bouin, 30000 Nîmes, France.; Service de Cardiologie, ELSAN, Clinique Saint Pierre, Perpignan, France. |
| Source: | Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2023 Nov 02; Vol. 25 (11). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: England NLM ID: 100883649 Publication Model: Print Cited Medium: Internet ISSN: 1532-2092 (Electronic) Linking ISSN: 10995129 NLM ISO Abbreviation: Europace Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2006- : Oxford : Oxford University Press; Original Publication: London ; Philadelphia : Saunders, c1999- |
| MeSH Terms: | Pulmonary Veins*/surgery ; Catheter Ablation*/adverse effects ; Catheter Ablation*/methods ; Lung Diseases, Interstitial*/pathology ; Lung Diseases, Interstitial*/surgery ; Atrial Fibrillation*/surgery ; Atrial Fibrillation*/pathology; Heart Atria/surgery ; Heart Atria/pathology ; Humans ; Adult ; Animals ; Sheep ; Catheters ; Treatment Outcome |
| Abstract: | Aims: The optimal interlesion distance (ILD) for 90 and 50 W radiofrequency applications with low ablation index (AI) values in the atria has not been established. Excessive ILDs can predispose to interlesion gaps, whereas restrictive ILDs can predispose to procedural complications. The present study sought, therefore, to experimentally determine the optimal ILD for 90 W-4 s and 50 W applications with low AI values to optimize catheter ablation outcomes in humans.; Methods and Results: Posterior intercaval lines were created in eight adult sheep using CARTO and the QDOT-MICRO catheter in a temperature-controlled mode. In four animals, the lines were created with 50 W applications, a target AI value ≥350, and ILDs of 6, 5, 4, and 3 mm, respectively. In the other four animals, the lines were created with 90 W-4 s applications and ILDs of 6, 5, 4, and 3 mm, respectively. Activation maps were created immediately after ablation and at 21 days to assess linear block prior to gross and histological analyses. All eight lines appeared transmural and continuous on histology. However, for 50 W-only applications with an ILD of 3 mm resulted in durable linear electrical block, whereas for 90 W applications, only the lines with ILDs of 4 and 3 mm were blocked. No complications were detected during ablation procedures, but all power and ILD combinations except 50 W-6 mm resulted in asymptomatic shallow lung lesions.; Conclusion: In the intercaval region in sheep, for 50 W applications with an AI value of ∼370, the optimal ILD is 3 mm, whereas for 90 W-4 s applications, the optimal ILD is 3-4 mm.; (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.) |
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| Grant Information: | Biosense Webster, Inc; Irvine; BWI-IIS-651 Investigator-Initiated Pre-Clinical Study Program |
| Contributed Indexing: | Keywords: Atrial fibrillation; High-power; Interlesion distance; Ovine model; Pulmonary vein isolation; Radiofrequency; Thin-walled structures |
| Entry Date(s): | Date Created: 20231018 Date Completed: 20231109 Latest Revision: 20240115 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC10629717 |
| DOI: | 10.1093/europace/euad310 |
| PMID: | 37851513 |
| Database: | MEDLINE |
Journal Article