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High-power short-duration versus standard radiofrequency ablation: Insights on lesion metrics.

Abstract：

INTRODUCTION:Radiofrequency (RF) lesion metrics are influenced by underlying parameters like RF power, duration, and contact force (CF), and utilization of lesion metric indices (ablation index [AI]) is a proposed strategy to predict lesion quality. The aim of this study was to analyze the influence of underlying parameters on lesion metrics of high-power short-duration (HPSD) and standard RF applications using an in silico and ex vivo model. METHODS AND RESULTS:An in silico simulation study was designed to simulate HPSD and standard ablations, in which ablation parameters could systematically be varied. For each simulated ablation process (n = 5732), the corresponding AI value was calculated. HPSD and standard RF settings were then applied in a porcine ex vivo model ( n = 120 lesions). The resulting lesion metrics were compared and analyzed regarding underlying parameters. RF applications of 50 W/13 seconds, 60 W/10 seconds, 70 W/7 seconds, and 80 W/6 seconds resulted in lesion volumes not significantly different from standard RF applications (30 W/30 seconds, P > 0.05). HPSD lesion diameters were significantly larger and lesion depths were significantly smaller ( P < 0.01) when compared with standard settings. Prolonging RF duration from 5 to 10 seconds resulted in a +27.5% increase, whereas a prolongation of RF duration from 35 to 40 seconds resulted in a +4.8% increase of AI value only. An increase of CF from 1 to 10 g resulted in a +73.0%, an increase of CF from 20 to 30 g resulted in a +10.1% increase of AI value. CONCLUSION:HPSD RF applications resulted in similar lesion volumes but significantly different lesion geometries when compared with standard setting RF applications.

journal_name

J Cardiovasc Electrophysiol

journal_title

Journal of cardiovascular electrophysiology

authors

Bourier F,Duchateau J,Vlachos K,Lam A,Martin CA,Takigawa M,Kitamura T,Frontera A,Cheniti G,Pambrun T,Klotz N,Denis A,Derval N,Cochet H,Sacher F,Hocini M,Haïssaguerre M,Jais P

doi

10.1111/jce.13724

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

1570-1575

issue

eissn

1045-3873

issn

1540-8167

journal_volume

pub_type

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High-power short-duration versus standard radiofrequency ablation: Insights on lesion metrics.