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In silico analysis of the relation between conventional and high-power short-duration RF ablation settings and resulting lesion metrics.

Abstract：

BACKGROUND:Use of lesion metric indices is a proposed strategy to support pulmonary vein isolation procedures and these indices show good correlations with lesion sizes. The aim of this in silico study is to provide a detailed analysis of radiofrequency (RF) settings, including high-power short-duration (HPSD) settings, and resulting lesion metric indices. METHODS AND RESULTS:A software program was designed which simulated virtual RF ablations. Lesion metric indices (Ablation index: AI, Lesion size index: LSI) were calculated based on underlying RF settings (contact force [CF], power, duration). In series of calculations, the applied settings were varied within defined ranges (CF: 1-80 g, power: 1-60 W, duration: 1-60 seconds). Overall, n = 388 000 virtual ablations were calculated. The resulting lesion metric indices were compared with each other and analyzed in relation to respective RF settings. Increasing contact force from 1 to 10 g resulted in a 4.4-fold LSI value, whilst increasing contact force from 10 to 20g resulted in a 1.5-fold value (P < .01). When RF power was increased by 10 W, lesion metric indices increased between 1.3- and 1.6-fold. A prolongation of RF duration by 10 seconds resulted in a 1.2-to-1.3-fold increase of lesion metric indices. HPSD RF applications of 50 W, 11 to 13 seconds, and 60 W, 8 to 10 seconds resulted in equivalent lesion metric indices when compared with 30 W, 30 seconds conventional ablations. CONCLUSIONS:The findings support the clinical use of contact forces within a 10 to 20 g range. AI is more sensitive to RF duration, whereas LSI is more sensitive to contact force. HPSD RF settings can successfully be derived from lesion metric indices.

journal_name

J Cardiovasc Electrophysiol

journal_title

Journal of cardiovascular electrophysiology

authors

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

doi

10.1111/jce.14495

subject

Has Abstract

pub_date

2020-06-01 00:00:00

pages

1332-1339

issue

eissn

1045-3873

issn

1540-8167

journal_volume

pub_type

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In silico analysis of the relation between conventional and high-power short-duration RF ablation settings and resulting lesion metrics.